Over the rainbow: research with an intersectional perspective

Posted by Dr Mark Adley, Research Associate, Newcastle University

• LGBTQ+ is an abbreviation for lesbian, gay, bisexual, transgender, queer or questioning, with the "+" sign recognising the multiple permutations of sexual orientation and gender identity.

• Intersectionality looks at how social inequities such as racism, sexism, or classism can interact and shape people’s social experiences.

"Reaching Out", pencil and pen drawing and digital collage by artist Sarah Li (2024)

In this Question and Answer blog, Mark shares some of his reflections on intersectionality when working with marginalised groups, and the importance of taking extra steps to make sure that the quieter voices are also heard. LGBTQ+ people are not a single group, and sexism, racism, classism and other social inequities can create unexpected intersections.

What was the focus of your PhD research project?
My PhD examined marginalisation in health and social care services in North East England, specifically looking at multiply marginalised LGBTQ+ people – those who had faced additional experiences of, for example, homelessness, substance use, racism, or domestic abuse. Seventy-two people across the region took part in interviews – 33 with professionals and 39 with marginalised LGBTQ+ people.

How would you explain intersectionality to someone new to the concept?
The shortest explanation would be that 1+1 does not equal 2. Intersectionality examines how different aspects of our identities can interact – creating unique experiences of discrimination. For example, a Black woman's experience isn't simply the addition of being Black plus being a woman. She may experience racism differently than a Black man, and she may experience sexism differently than a White woman. Her experiences as a Black woman are a unique intersection of race and gender. As Zora Neale Hurston perfectly captured in 1928: ‘I feel most coloured when I am thrown against a sharp white background’.

What challenges did you face in participant recruitment?
One major challenge was ensuring diverse representation. I noticed early on that lesbians and bisexual women were underrepresented, so I paused recruitment to address this. This led to an unexpected complexity – navigating the cultural and political debates around gender identity, particularly around use of the word ‘woman’ – and how to distinguish between cisgender and transgender women without causing offence.

How did you handle the sensitive terminology around gender identity?

It required extensive consultation with five women who held different perspectives on this issue. We eventually reached what I'd call a diplomatic compromise on language – while no one was completely satisfied, no one was seriously offended either. This highlighted the importance of careful navigation in sensitive cultural debates.

Recruitment flyers for lesbian, bi, queer, and pansexual women (left) and LGBTQ+ people of colour (right)

What adjustments did you make to ensure racial diversity in your study?

By March 2023 I had interviewed nine LGBTQ+ people from non-White British backgrounds, but only six were from non-White ethnic groups. After reflecting on the specific experiences of discrimination and invisibility shared by LGBTQ+ people of colour, I paused recruitment again. Following consultation with queer people from ethnically minoritised groups we rebranded the study, including removing rainbow imagery in favour of a brown background, as the rainbow was perceived as ‘very White-presenting’.

What key lessons did you learn about conducting research with an intersectional perspective?
The research required a constant shift in my own focus as a researcher. First, looking inward through reflexivity – examining my own unchecked biases and assumptions and their impact on how the study was conducted. Second, looking outward to understand the broader systems of power that influenced people’s experiences of marginalisation. It's a complex balance that requires both zooming in and out, while avoiding what has been called the ‘fetishization of complexity’.

The study’s key findings and recommendations

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Findings from the study are available in several formats

PDFs can be downloaded from the project’s website, with videos on YouTube and an Open Access scoping review published in BMC Health Services Research. Mark is involved in ongoing work exploring the experiences of LGBTQ+ people of colour, and collaborations with local organisations in consideration of intersectionality across the North East and Cumbria. To contact Mark or receive project updates via the mailing list click here.
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This study was funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) North East and North Cumbria (NENC) (NIHR200173). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Saying farewell to Fuse and celebrating its remarkable women on International Women's Day

Laura Ritson, Programme Manager, NIHR Three Research Schools, Prevention Research Programme, Newcastle University

We are marking International Women's Day by saying thank you and a farewell to Laura Ritson, who helped to establish Fuse in 2008 and has been integral to the Centre's success, while at the same time welcoming new Fuse Manager Agata Robertson.

In this post Laura talks about her journey with Fuse.

Celebrating Fuse's 10th birthday

After an incredible 16-year journey, the realisation that my chapter with Fuse has come to a close feels surreal. I am deeply grateful for the opportunity to have collaborated with an exceptional group of colleagues. Their contributions not only fuelled the growth of Fuse but also played a vital role in my personal development, fostering a continuous journey of learning and growth throughout this period.

Casting my mind back to 2008, I had the privilege of supporting Professor Martin White in spearheading an application to the UK Clinical Research Collaboration (UKCRC) for a Centre for Translational Research in Public Health. This ambitious venture united our five esteemed North East Universities in a unique collaboration dedicated to advancing world-class public health research. Our mission was clear: to enhance health and well-being and combat inequalities. Professors David Hunter, Charlotte Clarke, Janet Shucksmith, and Ann Crosland, among others, joined forces with us in this endeavour. The success of the application was made possible through the invaluable support of policy and practice leaders in Public Health, including Professors Peter Kelly and Eugene Milne. Their ongoing commitment to flying the Fuse flag is truly commendable. The Fuse funding was allocated for infrastructure to build public health capacity in our region. Securing funding alongside four other national centres forged close working relationships that have endured over the years. In 2009, I was delighted to be appointed as the Administrator for Fuse.

Reflecting on the past, our initial funding contract mandated a two-year review due to concerns about the complexity of our collaborative model, one which we passed with flying colours. Fast forward to today, and it's evident that collaborative efforts are now an integral part of our professional landscape. Embracing collaboration with practice partners and the public has been a significant aspect of our growth during my tenure with Fuse. How times have changed, and how exciting it has been to witness and contribute to this transformative evolution.

There have been so many highlights that it’s difficult to know where to start, and impossible to cover them all!

We underwent a lengthy process to identify our name, debating between Fuse and Rede! The communications agenda has grown considerably since we first established Fuse, and we have produced this award-winning blog and our public partner led podcast, and found many other creative ways to share our research supported by Fuse Communications Manager Mark Welford. The Fuse network has expanded to 2000 members, and we now have a dedicated Public Partner network, thanks to the support of Fuse Public Involvement and Engagement Manager Ella Anderson.

Another jewel in the crown has been AskFuse, a rapid response and evaluation service for our policy and practice partners. Special thanks must go to Professor Janet Shucksmith and Rosemary Rushmer, who were integral to establishing the service, and Dr Peter van der Graaf, Lesley Haley, and Annmarie Ruse, who have supported the development and continued to lead the way with a service that has also inspired and influenced the development of other regional and national infrastructures.

Capacity building has been integral to the Fuse endeavour, and it’s been great to see the development of public health leaders of the future. I’ve witnessed Fuse PhD students progress to senior-level careers in local authorities, prestigious NIHR awards, and professorial appointments.

I have been delighted to be part of the founders and planning of the Fuse International Conference on Knowledge Exchange in Public Health, and I am looking forward to connecting with colleagues at Cornell in June for the 6th International Conference.

Receiving the Director's Award from Ashley at the Fuse Awards 2023

I’ve seen many changes over the years, including in directorship to Professor Ashley Adamson. Working with Ashley over the last 10 years has been truly inspirational. A successful woman leader, she has steered Fuse through two renewals of its membership to the NIHR School for Public Health Research (SPHR) and also successfully directed the national School since 2017, with the support of a fantastic directorate team at Newcastle University who I’ve been fortunate to work alongside. I’ve also been inspired by the work of Professors Eileen Kaner, Carolyn Summerbell, Clare Bambra, Susan Carr, Monique Lhussier, and Amelia Lake. All of them challenged and helped me grow in the Administrator role, which expanded considerably between 2008 and 2017, enabling a strong case for a promotion opportunity to Fuse Manager.

In 2018, we moved towards a Fuse sustainability model, transitioning away from research council funding and towards Fuse partner University contributions, one which took time, effort and challenging conversations. Sustainability funding covers core staff costs and non-staff activities, including successful research events that serve as a key opportunity for disseminating our research, engaging in dialogue about implications for policy and practice, making new and strengthening existing contacts, and building a dialogue around research results and potential future projects. These events are a crucial forum for knowledge exchange. There has also been the development of the Physical Activity network and Embedded Researcher network which attract national level engagement.

In 2020, I was an integral part of a Fuse-led application to the NIHR Public Health Interventions Responsive Studies scheme, in which PHIRST Fusion was established. The Fusion initiative takes an evaluability assessment approach to co-producing evaluation design that addresses the priorities of Local Authority stakeholders. Due to my experience with Fuse, I led the communications agenda for PHIRST at a national level and helped secure funding from the Department of Health and Social Care for a dedicated Communications Manager post, which we now host within PHIRST Fusion.

I’ve been dedicated to working with Fuse for a number of years, drawn by; the people, nature, and variety of the Programme Manager role, the difference public health research is making to the population, and the flexibility I’ve had during my career to bring up my children through a combination of part-time and flexible working and during a national pandemic. I was also enthused by the challenge each day brought my way.

I’ve been grateful to Cheryl Wiscombe for supporting Fuse Administration and, more recently, Ann Payne, who has supported me with Fuse’s membership in SPHR. 

I’m thrilled to have transitioned into the role of Programme Manager for the NIHR Three Schools Prevention Research Programme, hosted by the School for Public Health Research, all while pursuing a part-time MSc in strategic leadership. Considering the latter, I had never thought myself capable of undertaking such a commitment. However, thanks to the support and encouragement of close colleagues, I've grown in confidence to seize this opportunity.

I extend my heartfelt gratitude to everyone who has shown dedication to Fuse over the years. I wish Fuse the best of luck for the future under the leadership of the new Director, Professor Sheena Ramsay, and Programme Manager Agata Robertson. I am confident that the coming years will bring both joy and challenges, and I eagerly anticipate following your progress, including the expansion of Fuse into Cumbria and the reinvigoration of the Fuse research clusters.

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Visit the Fuse website to meet new Fuse Manager Agata Robertson, as she tells us about herself, her interest in public health, and what attracted her to working with Fuse.

Creating an out of this world children’s book to help families affected by substance use

Cassey Muir, Research Associate from Newcastle University


To celebrate #WorldBookDay, Cassey tells us about going beyond the research to co-produce a children's story book to help families affected by substance use which is now freely available.

“To take the findings from our lived experience and create something real for families and people beyond the world of research has been brilliant” 

Young person involved in the project

Creating something real: How we produced a children’s story book

When I had the opportunity to create a children’s story book based on some of my PhD research that could help families affected by substance use, I was really excited to get started with the project. Ever since I was little, I wanted to write a children’s storybook and I had even mentioned this at my PhD interview panel, so being part of this project was a dream come true in many ways. 

To be able to create a book that has such meaning for the children and families involved has been incredibly rewarding, if not emotionally challenging at times. To help shape the plot and character development based on the stories of the young people that I had talked to during my PhD, felt like an enormous privilege but also a weight to get right. I wanted to make sure the story reflected the different experiences of children, while other members of the team were making sure the story reflected parents and caregivers’ experiences. Working with the talented Danielle Slade (author) and Josie Brookes (illustrator) helped make this process go as smoothly as possible. They were empathetic to the stories of families and wanted to keep to the integrity of family’s experiences and impacts, while making a story that was engaging.

With the creative minds of Danielle and Josie, we worked with 15 family members who were affected by parental alcohol or drug use, three teachers, Coram Life Education, and Coram Beanstalk to co-produce this storybook. Using techniques like free writing to music, drawing different characters, and storyboarding ideas, we involved children and parents in the creative process from the start. Families were also able to see early mock-ups of the book and feedback their ideas on improvements to the story and share their preferences on illustrations. Josie and Danielle were really receptive to the ideas from children and parents and valued their input.

We met with teachers from local primary schools and practitioners from Coram to think about who the target age range of the book would be, how the book could be used within schools and practice, and how to help adults have conversations with children. Through these discussions we developed conversation prompts for adults that are at the back of the book. These prompts (for example, what do you think of the Yozzle?) can help with discussing the characters and themes within the book with children in one to ones, in groups, or within a whole class setting. Anyone can follow along with this story of Arti, a wishing star. We have received positive feedback from practitioners where this book has been used with younger children (5-8 years), older children as a discussion point for reflecting on childhood (14-16 years) as well as with children who have special educational needs and disabilities.

We have also recently collaborated with Newcastle Film Club to produce a ‘story time’ video of the book being read by the author. This video allows the book to be accessed more widely and can be used alongside the book. Being able to produce this video, with Amy Mains (Director and Editor) and Scott Anderson (Director of Photography), who are also both teachers, was a fun and unique experience. We set up the equipment and reshuffled the backdrop in Fenham Library and managed to shoot the film in under two hours, just in time for the library opening to the public. I think this video adds an extra bit of magic to the story, with soft music and twinkling sounds!

 

Beyond the world of research: Creatively disseminating research findings

For context on the book, Twinkle, Twinkle Arti is a free story book co-produced with and for children who experience parental alcohol and drug use. This book helps start conversations between trusted adults and affected children. The messages within the book are based on two linked studies around the needs of affected families, led by Fuse Researchers.

The Safe Space project, led by Ruth McGovern, found that many parents and caregivers find it difficult to talk to their child about substance use and the impact upon the child and family. Parents and caregivers spoke about wanting resources to help with these conversations. Alongside this, research led by me, explored the experiences and support needs of children and young people. Children and young people told me that they valued the importance of confiding in a trusted adult such as a teacher, social worker, or family support worker but often did not know who they could trust or talk to, and prioritised approaches within schools which promoted conversations about parental substance use.

The story book captures the emotional and social impacts of living in a difficult family situation, from the perspective of the child and the parent or caregiver, and highlights helpful strategies to support the child’s wellbeing, for example talking about your feelings.

Using out of this world storytelling and fictional characters, the findings from these two studies are told in a way that makes them accessible to families and practitioners and offers positive messages and validation not only to children but to parents/caregivers and practitioners who find it challenging to know how to broach this sensitive topic.

We are freely sharing this book with families, schools, and practitioners across the country. To help understand the usability and impact of the storybook, we are gathering feedback from practitioners with a short online survey. This feedback will contribute to informing further development of the book and additional resources that are needed. I hope the book can be used across many different settings (schools, social care, and voluntary organisations) and can be shared with families who want to have those conversations. Within schools, we hope it is used in whole class situations, to reduce the stigma and show children they are not alone. It’s a fun story with fictional characters, and I hope families feel the book is engaging and non-stigmatising.

Here is some of the feedback that we have received so far about the book.

A practitioner told us: “It is so meaningful for children to know about the Yozzle [fictional character depicting alcohol or drugs in the book] and how it makes them feel. What a very complex idea to get across to children and yet it has been achieved with such skill!”

A child who reviewed the book shared: “It [the story] shows you’re not on your own and that there are other stars [fictional character depicting trusted adults] to support you.”

A primary school teacher shared the following: “There were no problems at all using Twinkle, Twinkle Arti in a whole class situation. In fact, I think it worked well as an introduction because it wasn't only alcohol use that the children discussed it was mental health, feelings, and how to overcome problems.”

A parent who helped co-produce the book reflected: “I am proud of the book because other children won't have to go through what my children have."

I think it is really important for researchers to work collaboratively with public, practice, and policy partners and to engage in creative processes that open their research to wider audiences. Through this process, you might learn something new and have fun doing it. But don’t just take my word for it, here are the perspectives of the illustrator and young person involved in the project:

Josie, the story’s illustrator, says: “This has been a really inspirational project, and a joy to work with Danielle, the research team, and all the families involved. We collectively believed in the power of storytelling to get these important issues across, and the resulting book is something I am so proud to have been a part of making. I think children will connect with Arti, her colourful world, and her story. I am excited for it to be used as a positive resource with children and families, in opening up those very crucial conversations, whilst simultaneously being so enjoyable to read!”

A young person reflected: “This book is something I would have loved to have been able to give to ‘little’ me, having something that related to my home situation when I was a child. I feel rewarded to be able to do this for ‘me’ now, for little me going through all those hard times and for all the children who will read this book, who are going through something, have a hard home life, have parents who are struggling, anything.

I hope through the book, we are able to show them that they are not alone and that there are people around them who are there to give them love and support. Hopefully, the book can help reach them earlier than I was reached out to. To create a book that would educate and support whomever read it, no matter their age or background, to be more than a storybook and to be able to help them, even in a small subtle way. It is a chance to reach the children that need it through a storybook that they come across all the time in life. It is incredibly rewarding to have a book that exists, that will last and be passed on to different children who are in a variety of situations for years to come. I am very proud of it.

I sincerely hope the book not only entertains children at bedtime, but that it can in some ways soothe a child's worries. It was an honour to hear the brave accounts from families and even more so, that they have trusted us to put their feelings and stories into this book.”

Fuse researchers and lived experience expert at book launch event. From left to right: Ruth McGovern, Kira Terry, Cassey Muir and Debbie Smart 

If you would like to learn more about this research, then please go to the links at the bottom of this page. And if you would like to join Arti on her journey of bravery, self-discovery, and learning about the important of talking about your feelings then take a look at the story book or watch the video.

Find out more

• Download the book free.
• Listen to this Fuse podcast to hear Cassey discussing her research on social and emotional resilience in children and young people affected by parental substance use.
• Read this Fuse news article about Twinkle, Twinkle Arti.
• Read this Alcohol Action Ireland blog and listen to the podcast.

All illustrations by Josie Brookes

What support do children and young people actually want when their parents use drugs and alcohol?

Posted by Cassey Muir, Fuse & NIHR School for Public health Research (SPHR) funded PhD Researcher from Newcastle University and Kira Terry, Lived Experience Expert. 

“No-one has ever asked me about how I feel in any of this.”

I found the powerful quote above from a young person during my research exploring parent drug and alcohol (or substance) use from the young person’s perspective. Since then the question of ‘what support do children and young people ACTUALLY want?’ has remained central to my PhD research in this area.

Most schemes focus on the parents themselves, to reduce the risk to young people. While these interventions are needed it should be alongside and in addition to support for the child or young person as well. There are currently a very limited number of evidence-based interventions for young people whose parents use substances, with low quality effectiveness. The distribution of support services for children and young people whose parents use substances is also patchy across the country, with practitioners doing really great work with little funding and resources.

In a recently published review of the research in this area, I aimed to understand the experiences, perceived impacts, and coping strategies of young people whose parents used substances. The review was extensive - covering the perspective of over 700 children and young people from across twenty different countries - and I hope that it can help to inform practice and policy through illustrative cases of young people’s experiences, as well as giving insights into what support could be useful.

Feeling different and isolated

Working with PROPS Young Person’s Project, a group of young people with lived experience supported the early stages of this review to help us understand the findings. One area that the young people felt was missing and may not have been explored across the current studies was the experience of feeling different to their peers, and how they felt isolated and like they had to keep everything hidden from others. This idea, relating to the experience of stigma, helped me to explore the data from a different perspective.

Children and young people described living highly disrupted and chaotic lives, characterised by unpredictability and insecurity within their relationships. They also often experienced adversity occurring at the same time in childhood, such as parents with mental health problems, domestic violence and abuse, as well as poverty. Children and young people were impacted both emotionally and socially from their experiences of parental substance use, which often extended beyond their parents stopping use, further highlighting that child-focused support is crucial. The painful experience of shame, stigma, and discrimination due to their close association and relationship with a parent who uses substances, was often further compounded for those who had experienced poverty or lower socioeconomic status.

Resisting and coping

Most of the studies described the negative impacts of parental substance, without recognising children and young people’s agency and attempts to change, control, and resist their experiences or impacts. Children and young people tried to manage and mitigate vulnerabilities and be resilient to unpredictable, adverse, and stigmatising experiences. While it is not a child’s role to resist and cope with the negative impacts of parental substance use, they were trying to do this anyway, often without formal support in place. Formal support was often thought of as something children and young people only have at times of crisis and due to the stigma and fear of speaking out it was also difficult for young people to seek support for themselves before a crisis point.

What can we do to support?

The findings had little to say about how young people wanted to be supported following their experiences. So, as part of my PhD I have been chatting with young people, and the practitioners that support them, around what we can do to support and build on their strengths, agency, resistance, and resiliency. For instance, young people and practitioners thought it would be good to develop a digital app that teenagers and young adults can access themselves at any time of day. They can choose what topics or sessions they want to go through and hear about other young people’s stories. Such digital interventions could be used alongside in-person support with a practitioner or act as a gateway to more formal support, with the aim of helping reduce the stigma of speaking out and accessing help. Additionally, young people wanted free text support lines that they can access out of hours, usually in the evening when things may be worse at home. Text and chat-based support lines provide young people with the opportunity to safely get support without having to physically talk to somebody and gives them more flexibility. Both young people and practitioners wanted in-depth training for professionals (e.g. teachers or first responders) around the experiences and impacts of parental substance use on children and young people and how to signpost to support.

Finally, one of the main areas that the young people and practitioners wanted to focus was on the co-production of resources to be used in primary and secondary schools. Young people wanted parent drug and alcohol use to be talked about in schools, as many reflected that it had never been spoken about making them feel more alone and isolated. Having lessons around the emotional and social impacts of family substance use within secondary school, or having story books read out loud in primary school about a child whose parent drinks alcohol or uses drugs would begin to reduce the stigma and fear of speaking about such a hidden and taboo subject.

“I’ve really enjoyed that chat, thanks for reaching out to me and wanting to hear about my experiences and how to support young people.”

Young person after taking part in this study

 

“He has told us he has gotten so much out of chatting with you and is really happy to have been involved and listened to regarding what might help others.”

Practitioner on behalf of a young person 

The young person’s voice

In any decisions made throughout my PhD, I have tried to ensure that the young person’s voice is lasting and at the forefront. Young people have been involved in this project from the start, guiding the research questions, designing research materials, contributing to ethics procedures, analysing data, and presenting results to over 100 practice and policy professionals. To finish this blog post, Kira shares her thoughts on contributing to this project as a Lived Experience Research Advisor and what she thinks is needed to support young people whose parents use substances:

“It has been an absolute honour to be involved as part of this project. To use my ‘negative’ life experience and be able to turn it into a positive impact for other children like me in the future: to help speak for those who feel they don’t have a voice and aren’t seen by people around them in the position they are in. The main part of supporting young children is accessing them and communicating with them. Reaching out to young people in general about parental substance use issues, getting the knowledge out there about it is important. This in turn will help the young people experiencing parental substance use, as the subject isn’t so hidden anymore as it usually feels hidden in the home. And through that we must back up with access to different support links. Some children aren’t ready, some don’t want help, some we won’t reach, but to push and be as present for as many children as possible, as long as possible and to reduce the isolation of the stigma around it is vital.”

Find out more about this research in the first Public Health Research and Me Fuse Podcast: How can we promote resilience in children and young people affected by parental substance use?

Links:

• Cassey’s first PhD Journal Publication reviewing the existing literature around children and young peoples' experiences of parental substance use.
• Cassey’s book chapter exploring stigma experienced by young people, which they may feel about their parent’s substance use.
• Fuse/Adfam Research Event recording with young people’s perspectives.
• PROPS Young Person’s Project.
• Adfam

Image credits:

1. Photo by Polina Zimmerman from Pexels: https://www.pexels.com/photo/young-woman-talking-with-therapist-3958461/
2. PROPS Family Recovery Service logo. Copyright © 2022 - All Right Reserved - PROPS North East: https://props.org.uk/

My passion for research comes from always asking "why?"

Posted by Pascal Landindome Navelle, FRSPH, Public Health Research Operations Officer and Doctor of Public Health Student at Teesside University.

In today's Fuse blog, Pascal gives his top tips for anyone starting out in research, and shares his own experience which began working with Fuse and Teesside University.

His advice? A passion for the "why?" question and accessing the right mentorship.

As part of the NIHR ‘Your Path In Research’ campaign.

 

After working as a clinician for several years, I felt that my impact on service users was limited. So, upon a thorough reflection, I was inspired to progress into public health research, where I felt I would have a broader impact on society.

Research work is fascinating as it provides a clear pathway to contributing to advancing the knowledge of the disciplinary sector to which I am dedicated. The importance of research should go beyond conceiving theoretical works that would only find a physical location in a library. Research should be "living", circulating, interacting, multidisciplinary, and impacting the environment.

What I enjoy about research is that it allows me to pursue my interests, learn something new, hone my problem-solving skills and challenge myself in several unique ways. Working on a faculty-initiated research project enables me to work closely with a mentor–a faculty member, and other experienced researchers. With a self-initiated public health research project, I can leave the community with a service that represents the distillation of my interests and studies and, possibly, a real contribution to knowledge.

There are many training and support systems that I have found valuable during my career. Researchers usually embark on increasingly diverse careers, where collaboration, networking and interdisciplinarity have become more important. Critical reading, academic writing and critical analysis are valuable training and support required of a researcher. Transferable skills, such as effective communication and problem-solving abilities, have helped me operate more effectively in different work environments.

Starting a research career can be daunting but exciting! The challenge of getting the support needed to achieve my dream came true when I enrolled at Teesside University for a research degree. This began by getting involved with AskFuse (Fuse’s responsive research and evaluation service) and with Associate Professor Dr Peter van der Graaf, working on an enquiry to evaluate Northumbria NHS Foundation Trust’s staff health and wellbeing resources during the pandemic, as part of my PhD research. This then led to working on the South Tees Arts Project (STAR) with Peter, a pilot study to co-produce wellbeing measures with primary school children, their parents, teachers, and artists for a school-based dance intervention. I supported the data collection, analysis and report writing for the STAR project as a Research Assistant and even wrote a song for the engagement activities with children in the research!

I had the opportunity of getting mentorship and some academic resources to enhance my knowledge. I connected and contacted very experienced researchers in the field of public health who supported my interest in growing as a research professional. Through the people I’ve met, I have had the opportunity to work on exciting but substantial research projects that have had a massive impact on the public health community.

My top three tips for somebody starting out in research are:

1. First and foremost, you should be motivated, passionate, and curious about your research topic – do it for science, not tenure! No one ever became a successful scientist with the sole premise of being awarded the Nobel Prize. And remember that plans rarely work out the way you thought they would.
2. Be prepared for a challenging career. Research is ever-changing. Be prepared for the change that research comes with strengthening your problem-solving skills to enhance the fun aspect of research. Problem-solving skills refer to handling difficult situations and overcoming complex challenges. They involve breaking a problem down into its parts, thinking critically about each element, analysing the information you find and using that information to form an effective solution. Having strong problem-solving skills will help make you an asset in your research practice and help you advance your research career.
3. Finally, be proactive, network and connect more with like-minded professionals. Sometimes, the key to getting to places is not what you know but who you know. We can learn a lot from talking to peers and senior colleagues. Attending symposiums, seminars and conferences is a great way to meet people who share common interests with you but have different experiences.

The NIHR has supported my career development through the provision of training, access to leadership development opportunities, networking events, mentoring and guidance on research funding.

The NIHR launched the Your Path In Research campaign this week. Better research leads to better services for the public. That’s why the NIHR want to encourage organisations and social care and public health professionals to play an active role in research, as a way to deliver even better services.

The Your Path in Research campaign highlights how people can make research part of their careers. Some amazing researchers have shared their experiences, how they started in research and what advice they can give to researchers that are considering adding research to their careers.

Take your first step in research today.

Now that's what I call blogging 2021

Posted by Mark Welford, Fuse Communications Manager, Teesside University

Let’s all channel British novelist E.M. Forster and play a little game of Only Connect. What connects the things below?

“Yes of course, they can all be a type of list” (said in the friendly yet ever so slightly patronising manner of host Victoria Coren Mitchell)

I think it's fair to say that we all love a list. I mean, the premise of another very popular BBC gameshow is basically to list pointless stuff.

So here again (a little later than advertised) is our annual list of the most-viewed Fuse blog posts of 2021!

You'd be forgiven for thinking that this would be dominated by Covid and the pandemic as we saw in the 2020 list.

Obviously, we had our fair share of pandemic related posts. Blogs about misinformation, food insecurity, malnutrition, obesity and what children made of it all. How it impacted on work and engagement with public partners, parents, decisionmakers, practitioners, policy-makers and commissioners. How it affected our mental health, our liberties and even inspired a song and a cat-scale of wellbeing!

But as you can see from the list below it didn't dominate the top 5 chart-toppers of 2021. Perhaps a little escapism goes along way...

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Katsushika Hokusai: The Great Wave off Kanagawa

5. The other third wave: a mass epidemic of very individual pain

Posted by Jack Nicholls, Lecturer in Social Work at Northumbria University

Lockdown restrictions were beginning to ease in the UK. But after the jubilation, what if you don't feel the way you think you should?

A very personal post by Jack Nicholls on the long-term mental health consequences of the pandemic, of lockdown and social restrictions, and of its easing. 

*Content/trigger warning: mental health, depression, suicidal feelings.

Page views: 938

Published: 16 April 2021.

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4. Patient and Public involvement with Parents during a Pandemic: the four ‘P’ challenge

Posted by Hannah Batten, Food and Human Nutrition undergraduate student at Newcastle University. Hannah was on a placement year with the Population Health Sciences Institute, as part of the MapMe study aiming to help parents assess child weight.

Body image scales on the MapMe website are being updated for MapMe2

"Most importantly, is to say to our participants that we are extremely grateful for their time and input, particularly during these uncertain times."

Hannah tells us how she and the MapMe study team met the challenges involved in recruiting and running an online Parent Involvement Panel (PIP) to help review documents and study materials, when parents were already dealing with a global pandemic. 

Page views: 1,029

Published: 5 March 2021.

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3. Should pregnancy 'be incentive enough' to quit smoking?

Posted by Susan Jones, Research Associate at Teesside University

In this blog post on #NoSmokingDay, Dr Jones explored deprivation, guilt, shame, stigma and the complex web of reasons behind smoking behaviour.

Just searched #smoking #pregnancy #incentives - struck by many tweets that say 'pregnancy should be incentive enough' to quit smoking. Clearly the stats tell a different story for a significant minority - the question surely is why and what can be done? @ASH_LDN @FreshSmokeFree

— Dr Susan Jones (@Susan_E_Jones) December 10, 2020

Page views: 1,155
Published: 10 March 2021.

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2. Things I wish I’d known when I started my PhD… (part 1)

Posted by members of the Population Health Interventions Programme at the MRC Epidemiology Unit

Research doesn't happen overnight, avoid comparison and channel your inner Arsène Wenger ("Le Professeur"). In our second most popular blog post, the early, mid and senior career researchers at University of Cambridge share their tips for PhD survival.

Here is part 2 which interestingly received only half as many views despite including a High School Musical reference.

Page views: 1,347

Published: 4 June 2021.

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1. Can Forest School inspire the next generation to be happy & healthy?

Posted by Katie Beresford, undergraduate student at Durham University

With more than 2,700 views this is our most read post of 2021 by some distance!

In it Katie explores growing up in the Lake District, embracing nature, finding school restrictive and struggling academically in her early years.

Nearly two decades later she is completing a Fuse summer internship with the NIHR School for Public Health Research and is tasked to review literature discussing the effectiveness of Forest School as a public health intervention.

Why not grab a coffee and take a walk with Katie into the woods to find out what she discovered...

Page views: 2,746

Published: 8 October 2021.

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So there you have it, the top five Fuse blog posts of 2021. Congratulations to Katie who wins a rare and coveted Fuse paperweight!  

Fantastically both Katie and Hannah's blog posts were part of our Fuse blog Student Series which we launched last year! This showcases posts by students who have been challenged to write a blog as part of their studies. The authors may be new to blogging and we hope to provide a 'safe space' for the students to explore their subject and find their voice in the world of public health research. Hopefully this will encourage other students to take the plunge!

As always, many thanks to our loyal readers and fantastic contributors.

Can we do any better in 2022? If you fancy giving it a go, please find out what we are looking for and how to take part here. All contributors receive a much sought-after Fuse badge.

Images:

2. Image: Katsushika Hokusai, (CC0 1.0), via Wikimedia Commons

4. Mr. Alexander Ottesen, CC BY-SA 2.5, via Wikimedia Commons

Find the gap: where is the healthy, enjoyable human body in policy?

Posted by Rachel Kurtz, PhD researcher at Durham University

Balancing varied and sometimes conflicting priorities within a large geographical area and between multiple departments is not a job to be envied. Ensuring the detail is suitably deliberated while also holding in mind how a policy affects other interests must be attempted but cannot possibly be achieved to perfection. My role on behalf of County Durham Sport was much easier. Over three weeks in June, I reviewed Durham County Council documents and the priorities of the Area Action Partnerships (AAPs) to identify areas of local strategy that did (or did not) address the issues of physical inactivity and the climate emergency. As an environmentally-informed, lifelong dancer-turned-researcher, I simply had to view the documents from two perspectives in which I am already personally invested and consider possible changes. Some interesting things emerged.

As you might expect, topics are viewed through whatever lens highlights policy concerns in that area. For example, the County Durham Plan understands physical activity functionally, through land use, waste, and movement of people, advocating for active travel (walking, cycling etc.) and providing and improving recreational areas. Meanwhile, the Joint Health and Wellbeing Strategy considers the environment as either beneficial or detrimental to public health, e.g. air quality. Thinking that is limited by departmental divisions can make it difficult to link overlapping policy areas. Consequently, councils are attempting to increase communication and collaboration by forming multi-disciplinary teams to create joint policy and consider issues from multiple perspectives. The County Durham Health and Wellbeing Board (author of the previously mentioned strategy) is one such team. This ongoing shift towards a collaborative approach is already countering siloed thinking and Durham County Council is taking a systems perspective through its work in Mental Health, from its strategic partnership both within and outside the council to delivery vehicles like the AAPs (which give local people and organisations a say on how services are provided). Nonetheless, a change of perspective inevitably exposes assumptions and raises new challenges, and this was no exception.

Encouragingly, some of the documents reviewed, such as the 2018 Open Space Needs Assessment, comprehensively address both focus areas, however in most cases the environment features more prominently than physical activity. A Physical Activity Strategy is still being developed, therefore gaps in this area might be expected and indeed in many cases the human body was entirely absent from policy. However, what was most noticeable was the underlying attitude where physicality was mentioned. Almost none of the policy documents feature the healthy, enjoyable human body. To cite a specific example: while addressing a rising mental health crisis, the Health and Wellbeing Strategy implicitly regards bodies as problems to be solved. This is particularly noticeable in the section on older people who are seen as frail and in need of preventative and remedial support. The framing of the strategy is already being addressed in this case but overall, any focus on the impact of health and wealth inequalities on the body tends to see physical inactivity as a problem rather than an opportunity. There were exceptions at delivery level (e.g. the Healthy Weight Action Plan and some AAP interventions, both of which are very much about enrichment) but at the strategic level, bodies are overwhelmingly framed as problematic. This is true even where you might expect an enrichment perspective such as the Children and Young People’s Strategy and Strategic Walking and Cycling Delivery Plan.

As a dancer and embodiment researcher this outlook is all too familiar, and I understand it as cultural rather than a failing of the council. In the main bodies are accommodated, objectified and treated as problems to be solved, while the sensual, experiencing body is largely ignored. Unfortunately, when we take this deficit perspective, we lose important, humanising opportunities for productive fun. Policy could be very influential in this respect. If we choose instead the underpinning belief that bodies are an incredible gift through which we explore and enjoy an endlessly engaging world, we automatically find more playful and interesting solutions. Suddenly new possibilities abound, like generating power from playground equipment or a dancefloor made with kinetic tiles. When we remember our sense of fun, urban environments become play spaces for curious bodies. Street furniture is for parkour, roller blading or skateboarding as well as resting. Outdoor games and gyms spill out of parks and line the route of our walking commute. Community growing spaces (already a popular solution to poor diet, food miles, climate change preparedness, physical inactivity, social isolation and low income) are no longer confined to small allotment plots but proliferate around the city alongside the begonias, encouraging healthy eating and a pedestrian habit.

Negotiating such varied needs and uses does of course require extensive consultation and consideration, which again highlights the importance of a partnership approach through which all voices are heard, but as I said at the outset, policy making is inevitably a difficult job. The bonus of reframing in this way is that by using strategies that are intentionally enjoyable rather than those that feel worthy or obligatory, uptake is likely to be far higher and as a result there is a better chance of achieving positive outcomes. Surrounded by the richness of creative human expression and snacking on free, community-grown fruit as we walk, jog, cycle or even dance our way to work and school, why would we choose to drive? 

Images:

1. Photo by Anthony Fomin on Unsplash

2. Photograph 'Exercise Machines' (2103264189_e26de7ba22_z) by Catherine via Flickr © 2007: https://www.flickr.com/photos/30325243@N00/2103264189 (CC BY 2.0) Adapted (cropped)

3. Photo by markusspiske on Pixabay

Things I wish I’d known when I started my PhD… (part 2)

Posted by members of the Population Health Interventions Programme at the MRC Epidemiology Unit

This is Part 2 of our PhD SURVIVAL GUIDE. In Part 1 we found out that doing a PhD (or any research) is challenging but the ‘this might be okay’ stage always comes; continuously comparing your work, and yourself, to others is the thief of joy; and research is a team sport and you're the boss so start channelling your inner Arsène Wenger!

Like most research groups, ours comprises an ever-changing cast of early, mid and senior career researchers. Our training is in a variety of academic disciplines and we all have different short, medium and long term life and career aspirations. While our experiences of public health research are naturally individual, we have noticed some commonalities. We share these here to provide reassurance to those new to the game that whatever they’re feeling is almost certainly ‘normal’. Challenging experiences are often interpreted negatively, particularly when they are first met. We propose that they can often be reassessed and reframed in ways that make them positive parts of a continuous learning and career development journey. Other people might have different experiences, this is ours…

 

Licensed to YouTube by: UMG (on behalf of Walt Disney Records); UNIAO BRASILEIRA DE EDITORAS DE MUSICA - UBEM, ASCAP, AMRA, LatinAutorPerf, Walt Disney Music Company (Publishing), LatinAutor - SonyATV, LatinAutor - UMPG, CMRRA, UMPI, and 15 Music Rights Societies

4. We’re all in this together – don’t take it personally

It is impossible to overstate the importance of not taking feedback personally. Opening a document containing feedback from your supervisor or peers and seeing a page full of colourful tracked changes and comments can sometimes feel like personal criticism. It’s all too easy to see this as a setback but in reality, this is what teamwork looks like. Your supervisor is there to ask the difficult questions, and to stretch you intellectually. All feedback is intended to be helpful, so you can produce a stronger output.

Trust us, your supervisor doesn’t expect perfection. Think they don’t receive similar feedback from their colleagues? Think again. But they’ve learned from experience that falling short of perfection is okay. Few imperfect ideas are that imperfect!

Also, what does perfect look like? There’s rarely a ‘right’ answer to any question, and there are different but equally valid ways to approach most things. Different is not necessarily better. Although you’re bound to immediately presume what you’ve done is ‘wrong’, our advice is to take a breath, remind yourself why you did what you did, and be prepared to defend that. This will be an essential skill for your viva! But remember to respect the time it took for someone to really consider your work, by reciprocating and carefully considering their ideas.

Your supervisor wants to see you succeed because your success is also theirs. Seeing your student flourish is immensely gratifying. It rewards everyone’s intellectual contribution to the work, and validates that seedling of an idea, planted by your supervisor, which has since blossomed under your care. Lastly, don’t forget that as much as you’re learning from them, they’re learning from you, too. You wouldn’t be doing that systematic review if they knew the answer already. 

"Piled Higher and Deeper" by Jorge Cham www.phdcomics.com

5. A PhD is a job, not a way of life

For most of us, reaching the start of a PhD represents lots of hard work and effort. It is tempting to think that means you should pour your life into research, and nothing but research, for three or more years, to do justice to that opportunity.

But your PhD can benefit from some down time. Giving yourself a mental break from research means you can return to work with renewed enthusiasm. Time away can also offer clarity and sometimes inspiration! Setting boundaries between research and the rest of your life can make the entire PhD process more sustainable and ultimately, more enjoyable. It can be easier to work efficiently and effectively in distinct working hours (even if those aren’t 9-5), with the incentive of doing something else that you enjoy at the end of it.

However, intending to take time off work and actually doing it are two very different things. During busy periods, it is easy to prioritise your PhD over other areas of life. It also becomes harder to switch off thoughts like “should I read that extra paper?” or “maybe I should do that analysis?” while you are trying to relax.

There are simple ways you can give yourself a better chance of achieving the elusive ‘work-life’ balance. Scheduling time – and protecting that time – to do a particular hobby, sport or social activity can help. It is much easier to rearrange a “hope to do yoga at some point this week” than a class you have booked at 7pm on Wednesday. Similarly, committing to doing things with other people is a great way to cultivate new friendships with colleagues, enjoy their company, and follow through with a plan. At times of self-doubt, it is also a good reminder that there are many other things you are capable of, and that life isn’t all about the PhD! 

6. Some bad things may happen that are not okay

A healthy PhD experience should be challenging, yes, but if this starts to have a negative impact on your physical or mental health and affects how you would normally function, something could be wrong. There are fantastic resources on the Mind website which are a great starting point to help you be more aware of your feelings. Struggling with mental health is very common in life and you are not alone. Seeking help and support is important though. Don’t be afraid to tell your supervisor if you’re struggling.

Sometimes though, the cause of these struggles can be external, and in particular, your relationships with supervisors. Supervisors are responsible for challenging you but also encouraging and supporting you. If there is a problem with your relationship, it is always wise to talk to your supervisor if you can, as they may not realise there is a problem. People are not always immediately compatible in their working styles; this is okay and can be worked through.

If a dysfunctional relationship is caused by a supervisor who is behaving inappropriately, this is not okay. Harassment or bullying of any kind should be escalated through the proper channels in your university. Speak to fellow students you trust candidly about your experiences too; you may not be the only one suffering and they could help support you through it.

The student always becomes the master

7. Enjoy every step of the journey

The good things that come from doing a PhD are not necessarily what you might expect. For some, the highest high is indeed right at the end, the crescendo, when the thesis is submitted. But for many this can feel like an anti-climax. The more you can learn to embrace and enjoy the process, and the less you anticipate what you think will be the good things, the more good things will come your way. A breakthrough with your data collection, your first set of meaningful results, mastering a new skill, or even just a meeting with your supervisor that goes particularly well, are all cause for celebration. Each milestone is a block that forms the foundation of your PhD and each one is a vital move towards your end goal. There is nothing more rewarding than the sense you are on the right track.

As you progress, you will also start noticing that people begin treating you like the expert you are becoming. You might not feel like it, but the student always becomes the master. As strange as these moments feel, you should enjoy them. They are an external reminder that you know more than you think you do. 

Occasionally you will sit back and realise, "I'm doing a PhD! And that’s pretty cool". Stop thinking that you need to have all the answers, or even that you know where your research is going, and instead realise you are there to learn and there to explore, wherever that takes you.

That’s it!

We hope that these points have been helpful, and that you are able to look back at these blog posts when it feels like everything is going wrong. Trust us, it most probably isn’t. We have all been where you are and have lived to tell the tale. Most of us would love to be in the position you are right now again, even just to spend time reading those papers that we still can’t get around to. Try your best to enjoy this incredible experience. You’ve got this!

Authors: Catrin Penn-Jones, David Ogilvie, David Pell, Dolly Theis, Emma Lawlor, Hannah Forde, Jean Adams, Jenna Panter, John Rahilly, Kate Ellis, Martin White, Matt Keeble, Nina Rogers, Rich Patterson, Roxanne Armstrong-Moore, Tom Burgoine, Yuru Huang.

Video: 

Song: We're All In This Together (From "High School Musical"/Soundtrack Version)

Artist: High School Musical Cast

Writers: Robbie Nevil, Matthew Gerrard

Licensed to YouTube by: UMG (on behalf of Walt Disney Records); UNIAO BRASILEIRA DE EDITORAS DE MUSICA - UBEM, ASCAP, AMRA, LatinAutorPerf, Walt Disney Music Company (Publishing), LatinAutor - SonyATV, LatinAutor - UMPG, CMRRA, UMPI, and 15 Music Rights Societies

Images:

1. "Piled Higher and Deeper" by Jorge Cham www.phdcomics.com

2. Courtesy of Henry_RS via Pixabay: https://pixabay.com/photos/darth-vader-luke-lego-star-wars-4344381

Things I wish I’d known when I started my PhD… (part 1)

Posted by members of the Population Health Interventions Programme at the MRC Epidemiology Unit

“By three methods we might learn wisdom: first by reflection, which is noblest; second by imitation, which is easiest; third by experience, which is the bitterest.” 

Confucius

Like most research groups, ours comprises an ever-changing cast of early, mid and senior career researchers. Our training is in a variety of academic disciplines and we all have different short, medium and long term life and career aspirations. While our experiences of public health research are naturally individual, we have noticed some commonalities. We share these here to provide reassurance to those new to the game that whatever they’re feeling is almost certainly ‘normal’. Challenging experiences are often interpreted negatively, particularly when they are first met. We propose that they can often be reassessed and reframed in ways that make them positive parts of a continuous learning and career development journey. Other people might have different experiences, this is ours…

1. Research is challenging but you’ve got this

"Piled Higher and Deeper" by Jorge Cham www.phdcomics.com

Research is certainly challenging. One of the first hurdles of the PhD will be trying to figure out how your research will contribute new knowledge to the area - this is one of the toughest challenges! Stick with it, because thankfully it does get a bit easier over time as you immerse yourself in the research and build your specialist knowledge. But even the most accomplished still find research hard. All the papers you read are from months (often years) of thinking, hard work, and negotiating multiple barriers - it doesn’t happen overnight. As a PhD student, you have the additional challenge of trying to do this in a short time frame, and it doesn’t always go to plan (which is usually out of your control). But, if good research was easy, anyone could do it.

An obvious interpretation of experiencing something as being difficult is to think that we, as individuals, are not up to it. The cycle of creativity suggests, rather glibly, that all projects are associated with a thought cycle that goes something like: this is awesome, this is difficult, this is terrible, I am terrible, this might be okay, this is awesome. We are not sure that we routinely experience the second ‘this is awesome’ stage. But push through because the ‘this might be okay’ stage always comes.

If you have been selected to pursue the PhD, your supervisors think that you are capable. You wouldn’t be on this journey if there were any real doubts about your ability. Encountering difficulties and making mistakes is normal and expected. Even those researchers you admire the most have moments of self-doubt, numerous journal and grant rejections and bad days when nothing goes right.

2. Comparison can be the thief of joy

Academic research is often experienced as highly competitive. In many ways it is. There is competition for limited research, studentship and fellowship funding; limited space in ‘prestigious’ journals; and limited podium time at conferences. This leads to the tendency to continuously compare your own work, and yourself, to others - and to experience a feeling of falling short.

It’s worth pointing out the selection bias present in the successes others share, and how most of the time we’re not seeing the full picture. Despite knowing this, we understand it is sometimes hard to see everyone else seemingly thriving, while you feel you’re just about surviving! Keep in mind that everyone’s PhD is different, and our successes will run to different timelines. And remember, you bring to your PhD your own unique skills and experiences. We’re confident that others are comparing themselves to you, too…

However, rather than continuously comparing yourself to others, we recommend trying to learn from them. If others appear to be succeeding where we are not, what, if anything, can we learn from their approach? Sometimes this will lead to the conclusion that there are better ways of doing things. Other times it might lead to the conclusion that the sacrifices required to achieve a particular outcome are not something we as individuals are willing to make. Or, indeed, that the outcome is not something we want.

We suggest being clear about what our own success criteria are and trying to stick to judging ourselves by those alone. These criteria can be set alone or with others in the context of formal or informal regular appraisals and personal review. At the risk of getting too SMART*-arsed, they should, at a minimum, be realistic.

Rather than interpreting others’ achievements as indicators of our own lack of success, we propose embracing and celebrating them. Informal and formal research group meetings achieve many things, but we see the sense of community that they build amongst ourselves as one of the most important. By embracing each other’s achievements we can support and build each other up, rather than letting comparison get us down.

 

Channel your inner Arsène - "Le Professeur"

3. Research is a team sport and you’re the boss

Completing a PhD might be seen as a lonely, individual pursuit. But while the end result is your own, you aren’t alone on the journey. In fact, research is a team sport.

Your home team is the one you share with your supervisor(s), and you’ll revel in the highs (and lows) of your PhD experience together. In this team you’re the captain. Lead from the front and manage your supervisors by communicating clearly with them, arranging supervision meetings and keeping them up to speed with your progress. As the captain, you make the final decisions related to your research and you are responsible for defending them. If you don’t agree with your supervisor then you should say so, and explain why. Your supervisor doesn’t want you to nod along, as the idea is to learn from each other and make better research (i.e. win) as a team. This can often feel really hard, especially early on while they’re still the experts, but they expect you to take the lead.

In other teams to which you’ll belong, you might play a different role but still make an impact. For example, you might run a writing group, attend group meetings or present in a seminar series; these are all important aspects of teamwork and becoming a valued member of the research community. You are also a member of teams that are less obvious. You probably aren’t sure now how the Facilities or IT department are going to help you achieve your PhD, but when you need a new chair or an obscure software package installed, be glad that you have them as teammates.

In part 2 next week: learning how not to take things personally, life isn't all about the PhD, bad things may happen that are not okay, and enjoying every step of the journey.

Authors: Catrin Penn-Jones, David Ogilvie, David Pell, Dolly Theis, Emma Lawlor, Hannah Forde, Jean Adams, Jenna Panter, John Rahilly, Kate Ellis, Martin White, Matt Keeble, Nina Rogers, Rich Patterson, Roxanne Armstrong-Moore, Tom Burgoine, Yuru Huang

*SMART Goals: Specific, Measurable, Assignable, Realistic, and Time-related

Images:

1. "Piled Higher and Deeper" by Jorge Cham www.phdcomics.com

2. Mr. Alexander Ottesen, CC BY-SA 2.5 <https://creativecommons.org/licenses/by-sa/2.5>, via Wikimedia Commons