Bridging the research industry 'Valley of Death'

Posted by Peter van der Graaf, AskFuse Research Manager / Fuse Knowledge Exchange Broker, Teesside University

I was recently invited to attend a meeting in the British Library of the Bloomsbury SET. Not a group of subversive English writers, intellectuals, philosophers and artists but an Advisory Council for an innovative collaboration between four partner Colleges of the University of London. Namely, the Royal Veterinary College; London School of Hygiene and Tropical Medicine; School of Oriental and African Studies; and the London School of Economics and Political Sciences.

Death Valley, Eastern California

The partnership is funded by Research England and aims to bridge the ‘Valley of Death’: supporting research projects that get stuck between university and the market place. It does this by creating a knowledge exchange platform between the four Colleges that accelerates the delivery of innovative scientific and technical solutions in the field of infectious disease and antimicrobial resistance.

Pronouncing pathogen emergence, zoonotic disease and antimicrobial whatsit was hard enough, let alone my hope of making a meaningful contribution. I thought I would feel completely out of place as a public health researcher and the only social scientist in the room, but to my surprise I quickly discovered that the collaboration faces very similar challenges to Fuse.

For example, the project is trying to pool their commercialisation expertise across the Colleges and create a ‘single open door’ for government agencies, big pharmaceutical companies, small and medium sized enterprises, and overseas partners particularly in Africa. So, similar to our AskFuse service but with industry. In spite of their best efforts to engage researchers from the different Colleges, the project leads found that not all academics are keen to engage in partnership working outside their immediate area of expertise and that interdisciplinary partnerships, particularly with social sciences and humanities colleagues, proved challenging, as they speak a different language and have different cultures for sourcing funding.

It also proved challenging to develop trusting relationships with industry partners: academics don’t know how to find these partners and engage them in their projects, while industry partners allege that academics are ignorant of innovate technologies that have been developed in-house. This is akin to public health researchers not being aware of different types of knowledge that are being used in local government. It takes time to develop these relationships and exchange knowledge within them, for which the three-year grant funding is not long enough to show full results.

While the partnership is keen to engage with social scientists about the social aspects of the commercialisation process (e.g. work with local non-governmental organisations on engaging communities and identifying cultural and societal perceptions around vaccine use and human health), Research England is more interested in the commercialisation of ‘hard’ intellectual property through licensing or spin-out. Hence, the key performance indicators are all skewed towards these outputs. In other words, the incentive structure set by the funder is not encouraging the very thing that the partnership is trying to achieve. This sounds very similar to the lack of incentives and career opportunities within universities for engaging in knowledge exchange in public health.

Group photo (me, furthest right)

During the meeting, the need for creating an infrastructure within the Bloomsbury SET that can facilitate conversations between academics across the Colleges and broker relationships with industry partners was acknowledged by the Advisory Council members. Dedicated funding to develop collaborative proposals between industry partners and academic researchers that address this need was suggested as a useful knowledge transfer mechanism. Similar to the Public Health Practice Evaluation Scheme (PHPES) operated within the NIHR School for Public Health Research.

In summary, even if you don’t have any expertise in a particular scientific field (and can’t even pronounce their topics), chances are that you have more in common and face similar struggles when moving research findings outside academic institutions, whether that involves industry or policy and practice partners. The Colleges study transmittable diseases from animals to humans but to have impact with their research equal attention is needed to the transmission of knowledge from one human sector/ academic discipline to another.

A nation stood still for 25 years: Can we find solutions for action in policy and practice?

Guest post by Ben Rigby (pictured), a postgraduate student in Durham University’s School of Applied Social Sciences and Associate Member of the Wolfson Institute of Health and Wellbeing Research



Fourteen – the number of pieces of legislation published since 1991 which specifically state ‘physical activity’ (PA) in the context in which Public Health England presents as a problem needing a long-term solution. That is, an unsustainable burden on the UK economy, resulting from diminished health and well-being, which may be alleviated by increasing population-level PA.

 

I want to help do something about this problem. For the next few years, I will be undertaking a North East Doctoral Training Centre ESRC-funded PhD to research how PA-related practice, evidence, and policy interact to benefit or disadvantage different population subgroups. This project will be supervised by both Dr Emily Oliver and Dr Caroline Dodd-Reynolds, co-directors of Durham University’s Wolfson Institute Physical Activity Special Interest Group. 

Although advances in public health policy and evidence have emerged, not least through the work of the Fuse’s Physical Activity Group on improving evaluation and translation, for example, there remains a clear disconnect between use of evidence, proper evaluation and the influence (and interference) of policy and politics in decision making and the provision of activity opportunities. Having worked for Hampshire’s County Sport Partnership for the past year, these are issues I have experienced first-hand.

 

As a practitioner, it was often difficult to translate available evidence into viable practice. Reasons for this were numerous, though included funding issues, difficulty in physically accessing research, as well as in understanding complex ideas of theory and evaluation, within the particularly vague policy context by which one was guided. Emerging literature also highlights issues in policy, such as failing to consider local implementation barriers, persistent participation inequalities or the intricacies of behaviour change.

 

The aim of my research will be to identify systems and opportunities that facilitate a more integrated relationship between PA evidence, policy and practice. In order to garner a holistic appreciation of these factors, it is vital to understand how policy makers receive, adapt and adopt evidence; how organisational factors constrain or facilitate its adoption and importantly, recognise values and interests of those influencing responses to the evidence or policy problem. A particularly neglected policy research topic has been individual or organisational capacity to act upon evidence.

 

Previous research has perhaps been somewhat one dimensional in these areas. Alternatively by employing a mixed-methods approach and my applied social sciences background, I will be able to generate a much-needed complex understanding of the extent that local, regional and national stakeholders use evidence in PA policy design and implementation, and review factors associated with successful policy implementation. Whilst building upon existing literature, it is intended that this will offer a unique interpretive perspective on people, practices and policy processes (both locally and nationally), enabling and supporting policy development and implementation.

 

Does sitting and talking, and a lack of progressive
 policy action, promote our sedentary society?

Specifically by investigating the following two core propositions initially, I propose that it may be possible to find equitable solutions for progress in increasing physical activity and provide an important contribution to the field of public health research:

1. Weak evidence results in inherently conflicting and ambiguous PA policy, thus constraining implementation efforts
2. Political entrepreneurs may offer more effective solutions for policy development and implementation 

Being a fledgling researcher
One of my relatives (a PhD recipient herself), once told me that doing a PhD will be the hardest thing I ever do. I am under no illusions about the task before me, the complexity of which may be compounded by investigating one of society’s most entrenched problems. However I welcome the challenge and cannot wait to get stuck in, even if a little part of me wonders if I have what it takes to make a difference in the world, as I am sure many new Social Policy researchers before me have. I hope that my research will land well and have impact in the academic sense, but also in tangible real life outcomes for local communities in time.

 

I am not alone in this quest, and hope over the coming years to work closely with Fuse and its focus on Translational Research; specifically, the Fuse Physical Activity group offers an important platform for me to engage with physical activity policy makers, practitioners and academics who I hope will engage with me in developing this programme of work. I believe research evidence should be free and accessible wherever possible, an issue I have already raised. I wish to experiment with how better to present evidence to make it attractive to both policy makers and practitioners. At the same time, I am conscious of having to develop my academic reputation and profile and balancing this with experimentation is something I am wary of at this stage. 

 

I wish to build networks within local institutions with like-minded students and academics to share ideas and findings. My aim is to disseminate throughout my project and beyond. I hope to be able to present to Fuse research fora, access advice and support from the group’s members, as well as contribute to this blog. I welcome any feedback on this post. In particular I would be delighted to hear from individuals, practitioners or groups who:

• have shared research interests
• are responsible for PA-policy production locally
• research health inequalities
• had difficulties implementing policy guidance and evidence
• believe research in this area may benefit their line of work

Ben can be emailed at benjamin.p.rigby@durham.ac.uk. He is also on Twitter, LinkedIn and has a blog.

 

Notes and References:

1. Figure taken 27 June 2016 – using the search term ‘physical activity’ at http://www.legislation.gov.uk. Between 1991 and this date 72,088 pieces of legislation were published. Results were manually screened and filtered for ‘physical activity’ as recognised by the World Health Organisation as benefitting health, well-being and personal and social development.
2. Bowen and Zwi.2005. Pathways to evidence-informed policy and practice: a framework for action.
3. http://www.mirror.co.uk/news/uk-news/john-prescott-battle-jeremy-corbyn-8720209.

How hard can it be? Flying over the gap between research and policy

Posted by Peter van der Graaf

A man in a hot air balloon realised he was lost. He reduced altitude and spotted a woman below. He came lower and shouted: “Excuse me, can you help? I promised a friend I would meet him, but I don’t know where I am”. The woman below replied: “You’re in a hot air balloon hovering approximately 30 feet above the ground. You’re between 40 and 41 degrees north latitude and between 59 and 60 degrees west longitude”.

“You must be a researcher,” said the balloonist. “I am,” replied the woman, “how did you know?” "Well,” answered the balloonist, “everything you told me is technically correct, but I’ve no idea what to make of your information, and the fact is I’m still lost. Frankly, you’ve not been much help at all. If anything, you’ve delayed my trip.”

The woman below responded: “You must be a policy maker”. “I am,” replied the balloonist, “but how did you know?” “Well,” said the woman, “you don’t know where you are or where you’re going. You made a promise, which you’ve no idea how to keep, and you expect people beneath you to solve your problems. The fact is you are in exactly the same position you were in before we met, but now, somehow, it’s my fault.”

This story was presented by Professor Roland Bal from Erasmus University in Rotterdam, the Netherlands in his recent Knowledge Exchange Seminar titled: ‘Hybrid management in science-policy practice relations’. You might have heard the story before, as it is adapted from an article by Locock & Boaz in 2004 in Social Policy and Society and also quoted in the PhD thesis of one his students, Rik Wehrens (2013), who studied the Dutch Academic Collaborative Centres for Public Health and how they shaped the co-production of research, policy and practice within this field in the low lands.

 

In his seminar Roland used the above story to explain that we often fall into the trap of thinking of two communities (ivory tower scientists on the one hand and policy makers at the coalface on the other) with completely different perspectives on the use of research and evidence. He did not deny there were differences between both professions, and gaps to bridge but suggested that we should use these gaps more strategically. By starting from a recognition that all science is a social practice quoting Jasanoff (2004) (“Scientific knowledge [..] both embeds and is embedded in social practices, identities, norms, conventions, discourses, instruments and institutions” (p. 2-3)) he showed how the Dutch Centres have been able to blur the boundaries between the two communities by distinguishing between a front and back stage for their partnerships and performing on these stages at different times in the collaboration process.

At front stage the academics took the limelight and made all the right noises about scientific rigour by presenting their advisory report to public and policy audiences, complete with imposing lecture theatres. They deliberately emphasised the difference between academics and health professionals to create the impression of ‘science speaking truth to power’. However, the content of the reports and the research behind were intensely debated behind the scenes on various back stages between academics, health professionals and policy makers to ensure that the research objectives and findings were embedded in the wider political context. In other words, collaboration and distinction were highlighted at different times in the process to enable each community to explain and sell their work to their peers: policy makers needed to account for their compromises and shared decisions, and academics needed to manage the expectation around their research.

Two key mechanisms provided crucial in this staging: firstly, dual appointments that enabled health practitioners to take up part-time roles in academia (but surprisingly not the other way round!) and, secondly, scenario approaches that clustered specific interventions into modelled scenarios connected to relevant policy programmes.

What lessons does this hold for Fuse? Are we still trying to bridge the two communities or should we spend more time developing different stages? AskFuse (our responsive research and evaluation service) might be a step in the right direction to create the back stage for initial conversations between policy makers, health professionals and academics but where is our front stage? Are we making enough noise? And how serious are we about dual appointments (researchers in residence?) and linking research on interventions to specific policy programmes?

You’ve lost that curry feeling: smell, memory and food research

Posted by Duika Burges-Watson

Grant Achatz, a survivor of head and neck cancer and one of the world’s most adventurous chefs, serves a dish in his Chicago restaurant Alinea that frequently makes people cry. Why would pheasant with shallots, cider and burning oak leaves do this and why should we care about some zizzy restaurant food? The principle is based on a neurological fact – our olfactory system is linked directly to the amygdala-hippocampus complex – the ‘substrate of emotional memory’ (Herz 2004, Soudry et al 2011). Research shows that autobiographical memories evoked by odour are significantly more emotional than those recalled with visual cues. It is sometimes called the Proust phenomenon – after a literary anecdote involving a Madeline biscuit and the recall of a powerful childhood memory. In Achatz’s restaurant, burning oak leaves are not eaten - they take you straight to the excitement of autumn.

Pheasant with shallots, cider and burning oak leaves

In the Fuse-led NIHR/RFPB-funded head and neck cancer ‘Resources for Living’ project, we have been running food play workshops to explore the potential of modern cooking techniques and ideas to improve survivors' eating and experience of food . In our workshop next week we are talking curry – it’s what many survivors have told us they miss the most.

As one of our survivors said:

The first meal I ever had with my husband was a curry. I had never been to an Indian restaurant until he took me in the early eighties. I couldn't believe the aroma the flavours and textures. He said he'd never seen anyone so small eat so much. I was hooked!

I used to hate it when people ordered their own curry and rice and put it all on their plate and didn't share. I liked to try a bit of everything to experience all the different tastes and textures. However I didn't like anything too hot and spicy. I found that too much heat from spice destroyed the rich flavours. So a Madras or anything hotter just seemed to lose taste.

The only thing I can eat now in an Indian restaurant is a bit of poppadum. It's a killer, watching my husband and daughter getting stuck in to a really delicious curry on the curry mile and me sitting with a glass of water. Help!

We will be using knowledge about food and memory, clever cooking skills and some of what social science can offer on food and eating, to create, and explore, a curry experience that cancer survivors can participate in. Curry is, after all, more than about the physical experience of eating. It’s where many Brits get to feel Britishness (speaking here as an Australian we do something similar with South East Asian food). We socialise around take-outs and eat-ins. Curry is also pretty intensely flavoursome, spicy and exciting to eat.

We knew when we started the ‘Resources for Living’ work that our research would have resonance beyond this patient group - head and neck cancer survivors have problems with chewing, swallowing, sore mouths, throat narrowing and damage, taste alterations, smell function decline and more (in various combinations) so their experiences are particularly relevant to understanding how we can cope with altered eating difficulties (think loss of taste and smell in ageing, neurological damage etc). But even for so called ‘normal’ eaters there is interest here. For starters (excuse the pun), do people with ‘normal’ eating habits talk about the relationship between food and emotion, food and thinking? This could be a component of food literacy, particularly in the context of modern manufacturing processes where odours can be created at will. Just think of the experience of supermarket shopping near the bakery section. Does the emotional trickery of circulating the odour of baking bread get you to buy more high fat/salt/sugar foods that you don’t need?

As people age, altered taste sensation can lead to all manner of new habits around food – how might the experience of smell be employed to re-engage those that have lost interest in food? Another example: taste disturbance amongst smokers is well documented; why don’t we employ food therapy to increase desire for a more flavoursome smoke-free life?

Remembering an odour memory yet? Perhaps not, but next time you are transported to a sweet childhood memory, perhaps you’ll notice the smell of it.

My Big Fat-and-Caffeinated New Year’s Resolution

Posted by Heather Yoeli

I need a coffee. I can’t write without coffee. Happy New Year. May 2013 be a year of love and blessings and decaffeination for you and all those whom you love. And please excuse the very inept deployment of the subjunctive in the previous sentence. I need a coffee, you see...

I’m sure I’m not the only one within Fuse to have made a New Year’s Resolution. I imagine that I’m not the only one within Fuse to have made a health-related behaviour-changing type New Year’s Resolution either. I am (deep breath) going to make fewer – alrightalright NO - trips to the friendly new espresso machine located at the local garage and I am (even deeper breath) going to put the money saved towards one of those cringworthily excruciating-sounding Mummy-and-Tot Dance Classes, through which I will instil in my progeny an enthusiasm (grit teeth) for exercise. And I’m wondering what New Year’s Resolutions others might have, and how forthcoming they might be in sharing them with a blog…

My vice. This is a caffeine molecule, apparently. Chemistry was never my strongest suit, so I’ll take its word for it.

Within most areas of health, healthcare and health sciences, there exists an ethos which says that professionals and researchers should distance themselves from their area of practice or study. If, for example, you’re a doctor or a PhD student with diabetes or bipolar disorder, it’s nobody else’s business at all and they can piss off if they ask you anything about it. You don’t go there because to do so would be unprofessional or self-indulgent or irrelevant or burdensome to others, in essence a transgression of Western society’s Cartesian boundary of subject/object, body/mind, Self/Other. In other words, our personal lives need neither to be affected by nor to affect anything we do to pay the bills. It’s all a stress-management technique or a coping mechanism or a survival strategy, and one with which few would disagree.

Within public health, however, ethical challenges emerge from attempts to uphold such distinctions. Even those of us who subscribe to the most deterministic and we’re-all-merely-victims-of-our-social-environment woolly leftie-isms would concede that we all exercise some level of choice regarding our health behaviour: we decide, for example, how much (if any) chardonnay we drink, how frequently (if ever) we disinfect our chopping boards and whether (if female) we turn up for smear test appointments. Merely by virtue of possessing some level of personal autonomy and merely by living in a country offering virtually universal health services, we are all patients (or service users, clients or consumers) of public health. And some of the choices we make with regard to our health will be visible or apparent to those with whom we’re working.

Within qualitative service evaluation literature produced on public health interventions in the Cowgate community, smoking is a case in point. Davies (1998) does not mince her words:

… some families spend a third of their income on cigarettes. The smoking message is one that the midwives repeat over and over again, and everyone, including social workers, seems to ignore it... 

Stacy (1988) puts it a little more discreetly:

Staff should decide whether to make reduction in smoking one of the objectives in their health promotion work.

In other words, if we can’t give up smoking why should they want to?

And if I’m wasting £2.30 a day on un-recycled paper cups of over-caffeinated beverages funding a monolithic rainforest-destroying global multinational, how can I think with any integrity about questions of ethics and sustainability with public health? I’m really [expletive redacted after long tea-fuelled discussion with editor] going to have to do this. Aren’t it?

So, before I put the kettle on for camomile tea in a vain attempt to assuage the shakings and cravings of my coffee withdrawal, would anyone else like to share what they’re resolving to do to address their own un-public health-worthy little vices? What’s your New Year’s Resolution, and why?

On tea, and what is normal

Posted by Heather Yoeli

There were two things which drew me to Northumbria University in seeking a Fuse studentship. The first was the refreshingly sociological and social justice based ethos within the health improvement focus of public health within the department. The second was the invigorating friendliness of its Coach Lane East canteen staff. And I’m writing this not to ingratiate myself to my supervisor nor wrangle another cuppa off my Go Catering loyalty card. I’m going somewhere with this, I promise…

One of the greatest contributions which the social sciences have made to the practice of health care has been their critique of fixed notions of norms and deviance. Whereas both conventional biomedicine and the biopsychosocial model assert the existence of an objective, positivist distinction between normality as healthy and abnormality as pathological or deviant, the social sciences tend to adhere to the structuralist or poststructuralist view that what constitutes the ‘normal’ is merely a social construction and thereby likely to change in response to a number of social, cultural or economic processes.

Nevertheless, it is my observation that academics from a range of disciplines of social sciences and health studying and working at a range of institutions possess a disturbing tendency to overlook this vital insight whilst operating a crucial instrument of research equipment: namely, the kettle. Even amongst academics with a resolute and impassioned commitment to language and terminology that is respectful, empowering, enlightened and anti-oppressive, there exists a tendency to express a preference for ‘normal tea’ (or sometimes ‘ordinary tea’). I would even contend that, were tea leaves to possess sufficient consciousness to comprehend the concept of prejudice, such a careless deployment of language would leave bags of Assam, Ceylon, Darjeeling, Earl Grey, green teas, redbush, peppermint, camomile, ginger, rosehip, lemon and numerous other blends feeling seriously discriminated against.

Certainly, such an unreflexively-assumed norm accords very closely with the way in which the UK beverage industry regards tea. Whereas Twinings and Clipper sell ‘English breakfast tea’ and Twinings also sells a cheaper ‘Everyday tea’, all other leading brands (Typhoo, Tetley, PG Tips, Yorkshire Tea, Cafedirect) simply market their product as ‘tea’. It is with Tesco own-brand basic of ‘Quality tea’ that the semiotics of this becomes clearest. However, I’d argue that social researchers possess a responsibility not to allow their attitudes to be determined by the global multinationals in control of the marketing industry. Peppermint tea must not be relegated to the deviant or abnormal.

The idea that the language we are given to use will insidiously determine our thoughts and attitudes is generally attributed to the polemic and scare-mongering of the literature of George Orwell. However, the idea has a rigorous and respected evidence base established through the ‘linguistic relativity’ research of Sapir and Whorf and more recently developed by Lakoff and Fairclough. Therefore, if academics within the social sciences can be manipulated by the tea manufacturers into talking about ‘normal tea’, it may only be a matter of time before they revert once more to talking about ‘normal people’.