Thursday, 18 December 2014

52 weeks in public health research, part 50

Posted by Mandy Cheetham, Amelia Lake and Mark Welford

It's all food, parties and away days in this week's Fuse blog picture post.  You'd think it was Christmas!


Posted by Amelia Lake: A balance? T'is the season to introduce your offspring to more sugary delights... Or is it a season for some balance! I like the balance option, some treats - both fruity and sugary!


Posted by Mandy Cheetham: A little (delicious) Christmas indulgence at the Health and Social Care Institute away day in Great Ayton, North Yorkshire. Reward for a morning's work including workgroups on software and apps (details below) designed to make our research life richer and easier!

Evernote & OneNote (information management), Inspiration & Prezi (visual mapping and presentational software), handling long documents in Word, and Twitter.


Posted by Mark Welford: Professor Graham Henderson giving a quick speech at his last staff Christmas party before he retires as Vice-Chancellor of Teesside University.  He resisted the urge to play a solo on the double bass temptingly placed behind him!

 
Posted by Amelia Lake: More food photos for the blog. Our traditional in canteen Christmas meal at Durham Queen's Campus in Stockton. With the obligatory whizzing balloons!
 
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A reminder from the Fuse blog group:

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

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

Email your posts to m.welford@tees.ac.uk or contact any member of the Fuse blog group.

Tuesday, 16 December 2014

Can’t cook, or won’t cook?

Posted by Joel Halligan, Research Assistant, Institute of Health & Society, Newcastle University

On Monday of last week, Lady Jenkin, a conservative peer, claimed that poor people 'don’t know how to cook'. She suggested this as, in part, a cause of the socio-economic patterning of obesity in the UK, and what followed was outrage, denial, and indignant broadsheet readers; but, is she alone in thinking this, and is she right?

Baroness Jenkin of Kennington. Photo used in the article on the Daily Mail website
One only has to look at the reader comments on the web articles to see that many people agree with her, blaming obesity on ‘the laziness of the poor’. So, it seems as though many people think of this as assumed wisdom. It has been found that people who are less socio-economically favoured are more likely to be obese, so this must just be down to the fact that poorer people don’t know how to cook, right?

Well, I’m afraid I’m going to disappoint you – the evidence just doesn’t bear this out. We recently did some analysis of data from the UK’s National Diet and Nutrition Survey, and our preliminary results tell us that the vast majority of people who were sampled reported that they could cook ‘from scratch’ just fine, even those in the poorer segments of society. Now, I’m not saying that poor cooking skills might not be a contributing factor towards levels of obesity, but it’s not as straightforward as suggesting that cooking skills alone are the cause and that simply providing them would be a magic bullet. Ask yourself this: do you know anyone who can’t cook and is as thin as a rake, or anybody who regularly cooks yet is overweight?

Lady Jenkin also said that: “If people today had the cooking skills that previous generations had, none of us would be eating so much pre-prepared food.” Again, this might seem like a nice, intuitive proposition, yet it ignores the complexity behind the shift that has occurred in our cooking and eating habits over the past few decades. Is it that we, as a society, are eating more pre-prepared food because we can’t cook, or that fewer people cook less often because there is such an abundance of convenient alternatives?

Lady Jenkin also goes on to compare the cost of her bowl of porridge to the bowl of sugary cereals that they eat, but, as I’m sure many will have considered, the cost argument also isn’t as straightforward as it may seem. Yes, the basic raw ingredients might be cheaper, but what about the cost of fuel and ‘opportunity cost’? Microwaving a lasagne for 4 minutes is probably going to incur a considerably lower fuel cost than if one were to fry the onions and mince, boil the lasagne sheets, and then bake it in the oven for an hour, plus that hour might be the only time of the day somebody gets to spend with the family, or relax, or do other necessary chores. Plus there’s the consideration that stocking the cupboards with an armoury of staples, herbs and spices also isn’t cheap, nor are the utensils and equipment needed to cook ‘from scratch’, nor are the cookbooks for the recipes (and remember that not everyone has internet access and thus freely able to trawl BBC Good Food for ideas on how to use up that last bunch of curly kale).

I’m certainly not saying that there aren’t people out there who don’t know how to cook, and there is indeed lots of interest as to whether helping people to cook can improve people’s diets, although it’s yet to be definitively proven that giving people cooking skills gets them to eat better: The Evaluation Report of Jamie’s Ministry of Food; Evaluation of a cooking skills programme in parents of young children; and Impact of Cooking and Home Food Preparation Interventions Among Adults.

So, I hope that those who were quick to agree with Lady Jenkin might reconsider their position, and remember that there are many reasons why people cook and eat the way that they do, and that it isn’t as simple as saying that if everybody could suddenly cook then convenience food manufacturers would go bust. In my humble opinion, there is definitely a place for cooking skills, and I do believe that they are an invaluable skill to have, but I also accept that convenience food is just that, and that it is here to stay, and that we need to take a more holistic approach to improving our diets rather than just extolling one type of cooking and bashing the other.

Lastly, I also challenge people to challenge their own preconceptions of obesity, and ‘the poor’ - perhaps next time you talk to somebody who fits either of those criteria, don’t assume they can’t cook, instead ask them what they like to cook – you might be surprised at their answer.

Thursday, 11 December 2014

52 weeks in public health research, part 49

Posted by Catt Turney Amelia Lake and Mark Welford

 
 Posted by Catt Turney: One of the photos taken by my colleague Britt Hallingberg at the DECIPHer symposium, where staff and students from the three partner universities (Cardiff, Bristol and Swansea) get together to discuss how our research is going and celebrate key achievements. As there are so many of us now we're only able to sympose once a year, and organising an ice-breaker at the beginning of the day is no mean feat. Luckily we had Dr. Jeremy Segrott (on the left, waving his arms in the air) on hand to conduct the task with aplomb. The ice-breaker involved a highly sophisticated and technically advanced approach to finding out our views on various subjects, by situating ourselves appropriately along a piece of string. This particular photo illustrates our views on mornings, about which we appear to have mixed feelings.
 
 
Posted by Amelia Lake: At this week's Fuse Members' Day - which was more popular? Fruit or crisps? (Disclaimer there were more bowls of crisps!!)
 
 
Posted by Mark Welford: Scott Lloyd demonstrating Mosaic, Experian's system for classification of UK households at the Fuse Members' Day. Mosaic is one of a number of commercially available geodemographic segmentation systems, applying the principles of geodemography to consumer household and individual data collated from a number of governmental and commercial sources. It's a bit scary how much it can churn out about you, your neighbours and where you live by simply entering a postcode!
 
 
Posted by Amelia Lake and Mark Welford: Fuse Director Ashley Adamson drawing to a close our Fuse Members' meeting at Durham University. A great meeting with lots of opportunities to catch up with colleagues from the five Fuse institutions and beyond!
 
The meeting was jointly hosted by the Fuse Communications Group and Knowledge Exchange Group and was centred around a blog post written by Scott Lloyd, Health Improvement Commissioning Lead, Redcar & Cleveland Borough Council.  He and his colleagues kindly agreed to give up there time to talk to us about improving partnerships, research and health.
 
This photo also shows off the new Fuse and AskFuse banners!
 
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A reminder from the Fuse blog group:

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

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

Email your posts to m.welford@tees.ac.uk or contact any member of the Fuse blog group.

Tuesday, 9 December 2014

The Stevens Factor – our man from Consett

Posted by Avril Rhodes and David J Hunter

Simon Stevens, the Chief Executive of NHS England is not as he seems. Behind the urbane witty manner, the man who likes, apparently, to speak without visual aids, is a man of real steel. Well, Consett steel actually, as at home speaking about his early experiences of working at the then Shotley Bridge General Hospital, as defending the NHS before the Public Accounts Committee and leading five year forward views. We have two gems here, someone who knows north-east England and relishes speaking almost exclusively about public health, despite the enormity of the operational responsibilities he carries, and definitely a force to be reckoned with, as his vertical rise from junior manager to CEO, via advising the Blair government at No 10, testifies.
Simon Stevens: a man of Consett steel
We shall soon be entering manifesto season. At his recent Centre for Public Policy and Health lecture at Durham University Queen’s Campus, whilst it wasn’t called a manifesto the audience were given an insight into six key priorities on Mr Stevens' mind, some of which built on the five year forward view released in October. Not in any kind of order these were:
  1. Re-conceptualising what we mean by the NHS – the NHS is now a pensioner, in organisational terms but is still revolving around dealing with problems as they arise, with too little spent on underlying prevention. It seems to be hard enough to co-ordinate the different services currently provided, let alone stepping up to a new level where there is no difference in health and social care, and any aspect of policy that affects life chances, and health and wellness, is integrated both in planning and delivery. But this is a goal that means a fundamental re-orientation of what’s provided, how and where.
  2. What about the unexploited advantages of primary care? The division between primary and secondary care in the UK, which has deep historical roots that pre-date the NHS is both a barrier, in terms of setting up a division that wouldn’t be recognised in some other countries, and also a positive, in providing personalised care, close to home. But what about the areas where primary care is all too thin on the ground, the unpopular parts of the country where GPs don’t want to work – the so-called ‘inverse care law’ which Stevens invoked. Can this be fixed through the development of a population-oriented primary care system?
  3. The NHS is a major buyer and employer and has a sizeable economic footprint in local communities. Back in his Consett days, the steel works had recently closed and the NHS took up some of the fall out as the local and large employer of alternative resort. This lesson has not been lost on Stevens. The NHS should be able to influence poverty and health through its own economic position in each locality.
  4. Work needs to be done on ensuring people get and stay in high quality jobs. The NHS can support this (partly linking back to the third point) through what it does as an employer but also could have a much stronger role in health interventions whilst people are at work. Unsaid at the time, but the workplace is somewhere people spend a lot of time, so why not? The NHS needs to set an example in being a good employer itself, but to its shame falls short, for example in the management of shift systems, or provision of healthy eating options at work. This was definitely a ‘can do better’ on the report card.
  5. Local Authorities have come back in from the cold with their new (or is it re-gained?) responsibilities in public health. There is an awakening to the scope local government could have, arising from the debate about devolution in England, set off by the Scottish referendum, and even within their existing powers, local authorities can reach the parts the NHS can’t reach in affecting population health and well-being. 
  6. And finally, what about the planning of new cities and towns? These could provide a test bed for working out new ways of place-shaping and designing health and wellness into the built environment and also new ways of delivering the NHS, given the blank sheet these major developments offer.
Let’s see how many party political manifestoes pay attention to these ideas in the Spring of 2015.

Thursday, 4 December 2014

52 weeks in public health research, part 48

Posted by Amelia Lake and Mark Welford


From Amelia Lake: A sign in an Italian cafĂ© in Shildon where the energy drink team had a meeting and were about to conduct focus groups. The team Steven Crossley (@akindoftrouble), Shelina Visram (@ShelinaVisram), Mandy Cheetham & me took the opportunity to look around the local area and sample local (Italian) cuisine!


From Amelia Lake: With a two-and-a-half year old the arrival of the festive season means the arrival of advent calendars. So far we've avoided chocolate ones. Long may that avoidance last!


From Mark Welford: Kaffee und Kuchen (coffee and cake) event for the Health and Social Care Institute to celebrate completing the move into our new quarters. The idea was to bring everyone together following the upheaval of the move from Parkside West - I wonder if a Kaffee und Frucht theme would have been as popular?! 


From Mark Welford: Peter van der Graaf getting creative with art supplies borrowed from his children. As an institute we have been challenged to take a selfie and come up with a three word statement that sums up our message to stakeholders for the School of Health and Social Care winter conference. The conference will focus on how we communicate with, and present ourselves to, our key stakeholders.

Our three words: 'Is this REFable?' The Research Excellence Framework (REF) is the system for assessing the quality of research in UK higher education institutions - it's all about research with impact!

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A reminder from the Fuse blog group:

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

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

Email your posts to m.welford@tees.ac.uk or contact any member of the Fuse blog group.

Tuesday, 2 December 2014

Working across boundaries

Posted by Scott Lloyd, Health Improvement Commissioning Lead, Redcar & Cleveland Borough Council
 
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Dear Academic, 
For the past nearly three years, we’ve been running this wonderful public health intervention in our area. It’s seen 50,000 people and everyone says how great it is. We’d now like you to come in and evaluate it. Oh by the way, there’s only two months of the project left and they’ve only got a few measures collected from past service users. 
Kind Regards,
Public Health Officer.
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Sound familiar? These instances have happened in the past and are unfortunate and I can’t promise that they won’t happen in the future. However, the frustrations occur both ways. Let me explain.

Research trials – especially large randomised controlled trials – cost a lot of money. They are designed based on the latest research to provide a degree of confidence that the outcome will add to the evidence base of what works. Even if they don’t work, it is still so very, very important that the findings are published and shared (Prof Richard Parish once suggested in a meeting that there should be a Journal of Public Health Interventions that don’t work).

Open door policy (and practice)
My frustration is when I hear about trials that have taken place and have failed to recruit participants in a timely manner or at all – this is one area where us mere commissioners and practitioners can help, especially now that many of us are working in Local Authorities with an even wider reach via colleagues in other departments. We can open doors that may be closed to you.

A few examples:
  • Are you conducting a trial with adults? Would you like easier access to potentially over 130,000 people in North East England? Through the medium of the North East Better Health at Work award, in 2014 colleagues worked with employers who combined to employ this many people. These colleagues and the Workplace Health Advocates that they work with could have been helping you.
  • Want to work with schools? Many of our colleagues – such as Healthy Schools (in some areas), School Sport Partnerships, Active Travel Projects and Local Authority education colleagues – already have contacts. Your information coming from them direct to their contacts will always be better than you contacting schools cold.
  • Communications teams in Public Health England, Local Authority, Clinical Commissioning Groups, NHS Foundation Trusts and elsewhere have a role too. They know the local media. They know our local populations. They have social media accounts with 1,000s or more of “likes” or “followers”.
There are examples where partnerships have worked really, really well. Look at “New Life, New You” in Middlesbrough. Also LiveWell; a number of colleagues have been involved in this during the development and implementation stages and the intervention team are close to recruiting the required number of participants.
 
My point is – get in touch early as I’d like to think that we can help. Senior researchers please advise your PhD students of these opportunities, especially those new to the North East. Fuse – especially AskFuse and the Knowledge Exchange theme – is breaking down barriers.
 
Even if we can’t help, it’s always good to know what is going on in our local areas (it can be embarrassing when we get asked about something that we know nothing about).
 
I can’t promise to change the world and that a joint approach will always work; but basically, as long as your intention is to improve health – I’m interested.

Thursday, 27 November 2014

52 weeks in public health research, part 47

Posted by Bronia Arnott, Dominika Kwasnicka, and Lynne Forrest


From Bronia Arnott: The only way (is Essex)? Recently I was in Essex and the queue of traffic with all of the “slow” warnings on the road resonated with me as I had just had a systematic review of interventions to reduce car use and increase more active and sustainable modes of travel accepted for publication.


From Dominika Kwasnicka: National Institute for Health and Care Excellence (NICE) strongly recommends that adults engage in any suitable form of physical activity. So you just need to pick and choose the one that’s best for you. Here is an adult version of a bouncy castle at a great event co-organised by one of Fuse's practice and policy partners Scott Lloyd. It’s always good to try new things. And if a bouncy castle isn’t your thing, how about some ice skating this winter?


From Lynne Forrest: A number of Fuse representatives, including myself, Shelina Visram and David Hunter, were among the 1500 delegates who attended the European Public Health (EUPHA) conference on Health Inequalities in Glasgow. This is my poster on a systematic review and meta-analysis that found no evidence of socioeconomic inequalities in stage at diagnosis for lung cancer.


From Bronia Arnott: An early morning trip to Newcastle Central Station which has recently been refurbished and is now looking much better. They even have some bike racks in decent places rather than stuck out of the way at the wrong end of the station. Coincidently, I was off to talk to people about active travel!


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A reminder from the Fuse blog group:

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

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

Email your posts to m.welford@tees.ac.uk or contact any member of the Fuse blog group.