Tuesday, 30 December 2014

Collaboration, Intimacy and Revolution

Posted by Emily Henderson

Heartened. How's that for an opener? It was my privilege this past August to present a paper at the European Association for Social Anthropologists biennial conference, hosted by Tallin University in Estonia. The theme was ‘Collaboration, Intimacy and Revolution’, in honour of Estonia’s 25th anniversary of their struggle and success in gaining independence from Russia after the Soviet fall.

Collaboration
The city of Tallin, Estonia
I am particularly grateful for this experience because of the importance of international exchange to my work. The panel I contributed to was entitled ‘Bodies out of bounds: anthropological approaches to obesity practices’. It aimed to rethink common understandings of obesity, and encourage interdisciplinary approaches to such a complex issue. I presented preliminary findings from my Wellcome Trust funded project exploring perceptions of the contribution of psychosocial factors to obesity. In short, I explore how cultural understandings of the causes of obesity and who is to ‘blame’ determines the ways in which all of us decide how obesity is to be addressed. I argue for the anthropological contribution to health interventions because it puts humanness and the human perspective and at the centre of these decisions. An outcome of this panel is an EASA special interest group, which I currently chair.

Intimacy
Brown peaty waters of the bogs, Lahemaa National Park
A shared issue that emerged from our collaboration was our belief that, while the study of obesity can be fascinating from a theoretical perspective, it also must be able to make an impact on health and wellbeing. The field of public health anthropology is considered ‘applied’ research, distinct from ‘pure’ research. This false dichotomy implies in the first that research cannot be both applied and generate theory, and that applied research is somehow ‘impure’. Central to social anthropology is ethnography and the personal contemplation it requires, as well as an emphasis on social justice. The translational research we do at Fuse - in particular through the coproduction model whereby those in policy and practice are equal partners in driving research - requires academics to give up their authoritative power over knowledge. This compels us academics to open up our disciplines to the world which is outside of our ‘pure’ surroundings.

Revolution
Lantern collection at the Kasmu Sea Museum, on the Baltic Sea
The other panel I attended was ‘Anthropology as a vocation and occupation’, which served as a forum for exchange on career prospects at a time when the global economic crisis threatens higher education. A main focus was on the ‘precariat’ researcher who is unable to find jobs or job security, (or more specific to academia, ‘cognariats’) many of whom are ‘early career’ researchers. A little bird told me we should give great thanks to postdocs at Durham University, because their external funding is used to run our offices. It’s a fitting analogy that we supply the lighting around universities. Rather than the term 'young scholars' perhaps a positive spin would be call us 'fresh scholars'. At this conference, I may have received the best professional complement ever: A fellow obesity ‘fresh scholar’ said my work asked the bigger questions; alas for him, he feels only permanent ‘academic staff’ in France have the luxury of thinking deeply. In a setting where The Rule of the Game is ‘Publish or Perish’, free thinking is one of the few remaining perks to being merely ‘research-only staff’ in higher education, and is the life raft to which we cling.

Past, present, future
Life grows out of a deserted Soviet submarine
base, on the Baltic Sea
Finally, Estonia really captured me. Taking a cheeky guided tour to Lahemaa, their largest national forest, I observed first-hand their love of nature, as over half their country remains forested. While cooling our toes in boggy waters, a local employed by Skype, a company created within Estonia, told me all about the cutting edge technology going on in Estonia. Our guide ‘begged’ us that if we were to remember one thing about Estonia, it’s that they are Baltic and Nordic people, distinct from eastern Europe. I was struck by Estonians’ ability to preserve their heritage, and also to innovate and make their mark as a new EU nation. Perhaps one will be their example of conservation. The lesson I took away from my trip was that in order to drive forward, we have to keep looking back. Given the opportunity of reflection on my trip, I felt revived and ready to face challenges forward. Presently, this means cracking on with the business of it.

This trip was funded very generously by Fuse and Durham University’s Centre for Public Policy and Health (WHO Collaborating Centre on Complex Health Systems Research, Knowledge and Action).

Thursday, 25 December 2014

Tuesday, 23 December 2014

52 weeks in public health research, part 51



Posted by Mark Welford: I imagine this is what every academic's Christmas tree looks like. This fine specimen can be found in the Learning Resource Centre of Stockton Sixth Form College. As far as Christmas decorations go, we really should be taking a leaf out of their book!   
 

Posted by Caroline Dodd-Reynolds: Finishing my Christmas shopping this week, all seemed fairly quiet at the MetroCentre 'gym'...

Posted by Dorothy Newbury-Birch: This is my last Christmas working at the Institute of Health & Society at Newcastle University. From 5th January 2015 I will be Professor of Alcohol and Public Health Research at the Health and Social Care Institute at Teesside University. Very exciting times. I promise to write a blog in January letting everyone know what it's like to be a new professor!


Posted by Mark Welford: Can you guess the theme of this book display at Stockton Sixth Form College? Answers in the comments section below.


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A reminder from the Fuse blog group:

Each week 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.

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!
 
------------------
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!
 
------------------
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
 
**********************************
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.
**********************************

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!


------------------
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, 25 November 2014

Bitten by the blogging bug

Posted by Sarah Smith

On the 1st of October 2014 I started my PhD. I felt excited and happy at the prospect and keen to get started, although I was a little sad to be leaving the research group that had taken me under its wing again. I feel very fortunate to be in this position and know it’s in part due to them really. My first task is to move my ‘things’ to the PhD office, all the way next door! Two years’ worth of research work needs sorting and it takes me a while (most goes into recycling) but finally I am set up in my new office space. I meet new officemates and all seems well. I meet with my supervisor, we chat about my work and I head off back to my new desk to begin my journey as a PhD student. Student? [thoughtful pause].

Using the word ‘student’ to describe myself seems strange. I’ve worked in research for 10 years already and feel that at my age I’m too old to be even a mature student. It’s made even stranger by the fact that I’ve worked in the same University, department and corridor even up until only yesterday. My whole status has changed overnight. I start to waiver a little. But after a coffee break and chat with new officemates I feel this newly acquired student status could work out just fine.

My fear of blogging is actually that of the unknown
During the first week, after the usual student-related teething problems I start to join up to activities offered by my department, and workshops and reading groups. I have the time to attend these now. The daily pace is slower than my previous role, there seem to be fewer demands on my time, I get headspace, I can think, I get to read, a real luxury! Things are looking more and more on the up.

My first student outing is to attend the Qualitative Health Research Writing Group Network meeting where Jenni Remnant introduces me to the world of blogging, something I’ve heard other people doing but never dared myself. She really sells it to me, that it’s a great way to network, and collaborate even with other academics, some out of reach normally. Then she sets us a practical exercise, to write a blog. Panic ensues. I draw a blank. I’m only a PhD baby of a week old; I have nothing to blog about. I glance around the room and everyone else seems to ‘get it’, writing notes, chatting about their existing blogs with others. I admit ‘I’ve never written a blog, I’ve never even read one’ to which people repeat my words back to me ‘you’ve never read a blog?!’. Am I so out of touch? Am I cut out for this? More panic ensues.

Then I start to think rationally and realise that my fear of blogging is actually that of the unknown and that I might do something I shouldn’t and once I do it’s out there in the ether. I’m reassured that as a first time blogger I can submit my blog, editors read it and will bounce it back to me if they think it or parts are not suitable for the public domain [sigh] I feel more comfortable about the idea now. But still, what do I blog about. Apparently anything, but it still seems daunting. I decide to embrace it and write a blog, but I’ll start tomorrow, then I’ll start the next day and it doesn’t happen, until I’m gently persuaded once more.

So today is the day, blog writing day. I open a blank word document and write ‘Blog’ at the top, the cursor blinking at me expectantly, and I have no idea what to write. Then I think back to where the blogging story began, the Qualitative Health Research Writing Group Network, and I remember my blog-writing fear, and I realise I’ve partly conquered that fear by even opening a Word document and being willing. I recall Sally Brown’s presentation at the meeting and a quote plays back through my head ‘don’t get it right, get it written’. And so I start typing, and typing. And the rest is history….

Thursday, 20 November 2014

52 weeks in public health research, part 46

Posted by Amelia LakeMark Welford, Sarah Smith, and Shelina Visram


From Amelia Lake: My office mate Duika Burges Watson (@debedub) doing her daily handstand #yogaintheoffice


From Mark Welford: Discussing blogging with Lisa Briggs and Kirsty Metcalfe from the Graduate Research School at Teesside University (@TeesUniResearch). They wanted to know all about the inner workings of a research related blog with a view to entering the blogosphere.


From Sarah Smith: Meta-analysis masterclass courtesy of the Centre for Reviews and Dissemination (CRD) York where I've been on the Systematic Reviewing course this week.


From Shelina Visram: Fieldwork for the HYPER! (Hearing Young People’s views on Energy drinks: Research) study is now underway. The focus groups with schoolchildren include a fun sorting exercise to explore perceived differences between energy drinks, soft drinks and sports drinks.

------------------
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, 18 November 2014

The 'C' Word VI: Crisis

Posted by Jenni Remnant and Libby Morrison

The Age UK Care in Crisis Report 2014 highlights the problem in Health and Social Care across the country with cuts in real terms; most councils are now only covering critical care criteria, so that those people with moderate needs will not be entitled to help.

Newspaper headlines shout out about the looming national crisis in care and public health for the elderly, and particularly the ‘ticking time-bomb’ of dementia. The number of people living with dementia looks set to rise year on year. How will our health and social care system cope with this – is crisis inevitable?

What perhaps isn’t highlighted is how, as with any crisis, it is a collection of individual experiences of people living with dementia and their carers.

An aged but blank piece of paper - having all the experience and history, but none of the words - because that's
 what dementia and Alzheimer's patients can seem like. It's there in the book, but you can't read it off the page.
 
The following diary extract is by someone recently caring for her elderly parents. Her mum was the main carer for her dad who was in late stages of dementia. Her mum had refused most offers of help as he was ‘HER husband’ and it was ‘HER job’ to care for him. She had become increasingly tired, and confused herself. The extract covers one weekend in crisis.

Friday

4.30pm
I went round to Mum and Dads to bring them some cakes I had made. I was met with a scene of chaos. Mum had packed up suitcases and bags which were stacked up in the living room. "What are you doing Mum?" She replied: "We don’t like this house, we are going back to our old one." I tried to explain that she couldn’t go back to her old house; they had sold it 7 years ago. There were pills in different bags, piles of notes and coins, clothes, rubbish etc. Dad was agitated of course, pacing up and down and making his ‘um um’ sound. Oh god what to do – Jessie is due back from school, the dog needs walked, I have a conference to go to tomorrow – I unpack all the bags and put everything away, make them tea and toast and promise to come back. Beg Mum not to leave the house with Dad. Run home make tea for Jessie, and walk the dog.

Dad once led a campaign to save the local library – and succeeded.

6.30pm
She's packed all the bags again and says her and Dad are leaving the house. She has drunk some whisky and possibly taken her sleeping pill. If I phone the GP or 999 they will probably take her to hospital – what then for Dad? He needs 24 hour care – where would he go? I have no space in my house and I need to care for Jessie and (just as an afterthought) go to work tomorrow! How can I do that – how can I not? If I don’t go into work I won’t get paid (care work – poor terms and conditions – ironic!). But the thought of Dad getting sent to any old place in an emergency, scared and alone, I can’t do it. Maybe if I can get them both to bed and to sleep, Mum might be better in the morning. Phone my sister and aunt to see if they can help tomorrow while I go to work. Ask my friend if Jessie can stay over with them tonight. Go to make a cup of tea – there is urine in the cutlery drawer – Dad has taken to peeing randomly in unexpected places. Clean out drawer. Make tea. Dad makes his ‘um um’ noise rhythmically and noisily – it drives me mad.

Dad was a school governor. He fund raised and campaigned to get new facilities and buildings for the local school.

10pm
They are both in bed (for how long is anyone’s guess). I make up a bed on the sofa and write this diary. I can’t sleep, although I am very tired.

3am
Dad is in the kitchen – peeing into a pie dish in which my aunt had brought them dinner yesterday. I clean up and lead him back to bed. He doesn’t object (thankfully).

Dad used to play tennis and rugby and was a big football fan.

Saturday

9am
My aunt arrives so I can go to work. Mum is a little better, seems less confused and has slept well. I hide the whisky before I leave. My sister and aunt go in to see them 3 times today. We have agreed to try and manage the situation until Monday, when we have a pre-arranged meeting with Social Services anyway as problems have been mounting over the last few months.

Dad set up and ran community education classes for local people.

6pm
Things are a little calmer tonight. Mum is clearly still confused but more reasonable. I cook them both tea. My aunt phones for an update. She says: "I didn’t think my toad-in-the-hole was that bad" when I recount the story of the pee in the pie dish!! We both laugh at that. But then I find myself in floods of tears – go upstairs quickly so they can’t see.

Dad has a glass plate which was presented to him for donating blood 75 times – there is a little certificate too.

9pm
I have given them dinner and we have watched a bit of telly. Mum doesn’t seem to know where anything is in the kitchen. Should we phone the doctor anyway? They will try and get us to bring her in to see them (I know of old). But that means bringing Dad and that means…….. oh let's leave it until tomorrow.

Dad loves singing and all sorts of music. He was once a choir boy in a big church in Edinburgh.


This is only the briefest of insights into the personal dimension of the impending dementia crisis, but in this limited glimpse at the nuanced and emotive narrative, it is already painfully obvious how much of a challenge public health professionals and researchers, and the health and social care structures in the UK have on their hands.

Thursday, 13 November 2014

52 weeks in public health research, part 45

Posted by Sarah Smith, Amelia Lake, David Hunter, and Mark Welford


From Sarah Smith: I attended the Public Health England work, health and wellbeing workshop on Monday in Manchester. This is Sam Haskell, Health and Work Lead from PHE, who used the Fuse logo in his presentation!


From Amelia Lake: I am grateful for the front of pack labelling which illustrate just how high in saturated fats & fats this prepared pizza is. Clear information is so important in terms of public health nutrition.


From David Hunter: Earlier this week I was involved in a Health Summit held at the Lindisfarne Centre in Durham to discuss and debate the challenges facing governance for health. We had a reception and dinner at the Castle on the first night and the event was attended by around 30 invited participants from across Europe, mainly from the UK. Partly organised to launch our WHO Collaborating Centre on Complex Systems Research, Knowledge and Action. Pictured are the speakers from the event.



From Mark Welford: Boxed, labelled and ready to go. We (the staff, students and researchers) at Teesside University's Health and Social Care Institute (HSCI) are moving offices from Parkside West to the much more central Constantine Building.   

Teesside University was originally founded as Constantine College and was officially opened by the Prince of Wales, the future King Edward VIII, on 2 July 1930. Below is a photo of two plaques that can be found on the wall of the Constantine Building.  Although you can't really see it clearly in the photo, the one above commemorates the fact that the college was a gift from local shipping magnate Joseph Constantine and his family and the one below marks the date when the college was officially opened.
    

The college became a polytechnic in 1969; and in 1992, the Privy Council gave approval to 14 higher education institutions, including Teesside, to become new universities.

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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, 11 November 2014

Nacademia

Posted by Samantha Level

Thoughts of a ‘nacademic’ (a cross between a ‘naka’ (no knowledge of any worth) and an academic (a longing to have knowledge of worth)).

According to the urban dictionary
'Nacademic; Nakk-a-dem-ik (noun). A person who claims knowledge in a particular subject, however they do not possess any kind of merit to back up such claims.' 
Manuel from Fawlty Towers played by Andrew Sachs
In the words of the loveable Manuel from Fawlty Towers ‘I know nothing’ (ironically from the episode communication problems and repeated by me in the worst Catalan accent imaginable). I feel that phrase pretty much summed up my first year as a part-time PhD student - especially when talking to academics and / or other postgraduate students, probably not so much when talking to non-academic friends. Now at the end of my second year I don’t feel that dread of someone asking me about my research for fear they will delve too deep into the abyss of my empty head expecting me to retrieve data that has not yet been collated, rather now I feel a hint of, dare I say, ‘confidence’.

In the beginning talking to other new students actually made me feel inferior. Some of them already seemed so knowledgeable, with clear aims and objectives, plans of their chosen methodology and some even knew about theory! How I was jealous of these people (or aliens as they might have been).  Whereas, I just had passion to learn (or as Jarvis Cocker said in the song Common People a ‘thirst for knowledge’) and the stubbornness not to quit. It didn’t help that a lot of the articles I attempted to read made me feel like self-diagnosing myself with narcolepsy, but with a dictionary at hand ready to translate I persevered - and here I am progressing to my third year.

My advice would be if, like me, you suffer from the paranoia of empty head syndrome (trust me, you’re head is NOT empty but in those dark moments of self-paranoia you may feel it is) - start off talking to other post-grads that may not be from your subject area - this way you learn to talk about your research without worrying that they may know more than you do about ‘your’ topic. I attended a three day researcher training event held at Durham University and I have to say the invitation to this arrived at a crucial time for me as my confidence levels were so low I wondered if I was even ‘smart’ enough to progress to year 2, let alone complete a PhD. Once there I chatted to others - many of whom felt just like me. They were from all areas - engineering, medical, psychology and so on - and this was the first time I felt I fitted in as a post-grad.

I guess the message I want to relay is that if you’re reading this and think OMG (editor: that's 'Oh my Goodness' for those who remember a time before text messages!) that’s me - I’m a nacademic, then don’t feel alone and hang on in there - the ‘naka’ section disintegrates (albeit often slowly) and you will emerge like a beautiful academic butterfly (or in my case more of a moth but still at least materialising into some form of an academic ….)

Thursday, 6 November 2014

52 weeks in public health research, part 44

A day in the working life of Amelia Lake


Today has been about cars and traffic. Moving from one bit of the North East to another - all in the name of Fuse! Truly wish I'd been on a train - then I'd get work done...


Refuelled at Durham University and time to head to the Wolfson Research Institute for meetings with the rather fabulous Fuse energy drink team...


It's meeting 3 in a three location day hampered by horrendous traffic. I'm feeling weary but I'm energised talking about our Fuse energy drink research...


Big word of the week - courtesy of my colleague Stephen Crossley (@akindoftrouble).

------------------
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, 4 November 2014

Knowledge exchange: just do it (but be mindful of what you say). Part 3 of the KE blog series

Posted by Peter van der Graaf

In the last two blogs about knowledge exchange Avril and Mandy did a great job outlining the opportunities and pitfalls of academics working with public health practitioners and commissioners to get research into practice (or practice into research as a more subversive strategy). “Putting yourself in the shoes of service partners”, “connecting with people in different ways”, “demystifying the language” all makes sense but how do you do it? The toolkit provides plenty of ideas but until you put those ideas in practice your translational research skills are still untested.

AskFuse was set up in June last year to ‘just do it’ (incidentally a research manager was hired with strong connections to the American company that came up with the slogan): ask our policy and practice partners what evidence they need and then find academics in Fuse who can help them access or develop that evidence in a timely, useful manner and in a usable format. Almost 16 months and 100 enquiries later, there certainly seems to be an appetite for working together.

That doesn’t mean pitfalls no longer exist: procurement procedures can trip up the best laid proposals, reorganisations are still not conducive for collaborative research, academic language can be intimidating and impenetrable, and academics can be just as invisible to each other as they can be for policy and practice partners.

However, having conversations seems to be at the heart of any successful (and unsuccessful) collaboration. Moreover, what happens in these conversations is key. Below is a hypothetical conversation between a Fuse academic and health practitioner based on similar experiences within AskFuse. What this exchange highlights is not only the stereotypical views that exist on different sides of the fence but more importantly the ability to change our views about doing research with policy and practice partners. That doesn’t mean academic rigour and peer reviewed publications are out of the window. 'Rigorous' is after all an adjective not a verb, and changing a health policy or intervention is what ultimately improves public health, not journal ratings or citation indexes.

In a sunny office somewhere in the North East:

Public Health practitioner in Local Authority: I would like to know if my child obesity programme in schools is going to work before I ask commissioners to sink millions of pounds into it.
Fuse researcher: No problem. What you need is a full RCT with three arms after a feasibility and pilot study, followed up by a mixed methods impact evaluation after 24 months.

Practitioner: Great! When will I have the results and what will it cost me?

Researcher: Only £1.2 million pounds and 7 years of research.

Practitioner: But I need to convince the elected member in the Council, who decides on my budget, in 6 months’ time and I have only £15,000 available for research within my million pound intervention programme.

Researcher: Right, so what you really want to know is: do the children in my programme lose weight. What? You are already measuring this within the programme? And you have comparable data available through the National Child Measurement Programme? This is highly unusual! You are also more interested in why children do or do not engage with the various activities on offer? Why didn’t you say so! All you need is a process evaluation: some interviews with delivery staff, group interview with some of the children and parents and Bob is your uncle! We can even use some comparable data from a previous research project to inform the questions and speed up the research design process.

Practitioner: Fantastic! I am sure if you write a short outline to explain this to my boss, nothing too fancy you know: just bullet points and a nice picture or story will do, we can find a way around those nasty procurement procedures. I might even invite a colleague from the neighbouring local authority to join in as he is doing something similar and also has some funding hidden away from his colleagues in other departments, who are all too keen to get their hands on our ring-fenced budgets. He is quite busy at the moment but is available in eight months’ time.
 
Researcher: But wait a minute: you said there was no money and time? How do we know if your colleague will still be interested eight months down the line and how will we know if the research findings will apply to his patch? Surely his boss will have different ideas about spending that money. 

Practitioner: I think that’s where we will need a full RCT. Wasn’t there something about complex interventions mentioned in an earlier Fuse blog?

Thursday, 30 October 2014

52 weeks in public health research, part 43

Posted by Amelia Lake, Emily Henderson, Lorraine McSweeney and Peter Van Der Graaf


From Lorraine McSweeney: It was a proud and surreal moment to see my PhD thesis join eminent academics’ work on the Fuse Director's bookshelf of fame at Newcastle University!


From Amelia Lake and Emily Henderson: Emily has fashioned a temporary standing desk so we, at Durham University's centre for public policy & health, can introduce a bit more activity into our working life!


From Amelia Lake: Halloween a time of... excessive sugar intake? What happened to carving turnips, eating satsumas and the best treat (well in the Lake household circa 1985) a big box of pomegranates!


From Peter Van Der Graaf: Poster presentations at the 1st International Conference on Realist Approaches to Evaluation and Synthesis with two posters from Fuse's Monique Lhussier (see below). A surprising amount of papers and presentations on public health including a keynote address by Professor Mike Kelly from NICE.  Is Fuse missing a trick?



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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.