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What can students do to make the most out of their Master’s degree?

e.schaessens8 July 2020

By Louisa Manby and Kirsi Sumray

We are both students on the Population Health Masters programme at UCL. Louisa came to UCL after undertaking a BSc in Biomedical Sciences at The University of Manchester. Kirsi completed a BA in Anthropology at The University of Bristol in 2017, took a gap year and then worked for the British Red Cross before returning to academia. We have three tips to share with you from our own experiences about how to make the most out of your time at UCL.

Research opportunities

It is absolutely possible to find research opportunities outside of your degree programme. There are multiple health related institutes at UCL including the Institute of Global Health, Institute of Applied Health Research and the Institute of Epidemiology and Healthcare. From our experience, the best way to find research to get involved in is to reach out to academics that work in areas that interest you. Academics frequently have research that Master’s students can volunteer to participate in which isn’t advertised – the only way to find out is to get in contact.

Given the relevance of our Masters, we were both really keen to get involved in research on COVID-19 at UCL. Through reaching out to academics we became aware of new research being run by RREAL and were delighted to be given the opportunity to get involved. RREAL is the Rapid Research Evaluation and Appraisal Lab with international networks co-directed by Cecilia Vindrola-Padros and Ginger Johnson at UCL. RREAL aim to produce relevant and rapid qualitative health research in time-sensitive contexts. We have both joined the RREAL team in conducting their research relevant to COVID-19. This has involved a rapid appraisal of healthcare workers’ perceptions and experiences of responding to the COVID-19 pandemic through analysis of the relevant media, social media, policies and using interviews with healthcare workers. We have been involved in research relevant to the UK, although the study is also being mirrored internationally in 18 countries (at the time of writing). Emerging findings from this research will be published shortly – make sure to look out for this as it will be both of our first publications! Some of the teams’ future publications will consider the impact of the delay or cancellation of elective surgeries, the mental health of healthcare workers and the impact of working in palliative care in the UK during the pandemic. Alongside our UK research, we have both been involved in an opinion piece on the potential impact of COVID-19 in lower- middle- income countries. This paper will be published soon – it makes recommendations based on learning from previous experiences to minimise the impact of this pandemic on fragile healthcare systems. Despite supporting different streams of data collection and analysis, we have both gained valuable skills in conducting qualitative research. We are both really glad that we reached out to find these opportunities and would really encourage others to do the same – you won’t know what’s out there unless you give it a go!

Extra-curricular activities

In order to build on what you learn in your Masters, UCL provides many opportunities to attend events, join societies and go to conferences and free talks from different departments. There are a number of different societies at UCL related to health which include the “Students for Global Health Society”, the “MedTech Society”, the “Application of Psychedelics Society”, “Student Action against Homelessness Society”, “Friends of Médecins Sans Frontières” amongst many others. These societies offer events with opportunities to network with experts and like-minded peers, as well as interesting lectures and stimulating debates. It is very possible to attend events at UCL around your studies, as they are often scheduled at lunch time and in the evenings. In fact, UCL has been running a series called “Lunch hour lectures” since 1942, these lectures are open to everyone for free! These have continued virtually throughout the pandemic and have been really great as a mid-day break from dissertation writing. For example we have recently attended two lunchtime talks called “Trump 2020 and America in a post-COVID world” which was by a lecturer in Global Politics and “Insights from the COVID-19 crisis: useful for the UK’s energy transition to net zero” which was by a Research Fellow at the Energy Institute, BSEER. We would really recommend attending talks and events as they broaden your knowledge beyond module content. They can also be useful for identifying your specific interests which is important for deciding optional modules, dissertation topics and even future careers.

Networking

One huge benefit to seeking research opportunities whilst at UCL and also in attending extra-curricular talks and events is networking. Through attending talks we have been able to meet experts in the field which has been really useful for us to be able to ask career specific questions. Also, through the research that we have been undertaking at RREAL, we have made global connections and built relationships with students from different institutes, public health consultants, and academics from both UCL and other internationally renowned institutions. Networking can be really useful and getting to know people within the different institutes can help with finding a dissertation topic/supervisor and learning about different career paths. If you do this early on you may even find a unique dissertation opportunity that interests you. This is what Kirsi did, she was keen to learn more about digital health interventions so reached out and was able to find a dissertation within a different institute titled “Assessing inequalities in access to STI self-sampling kits across the UK”. Although it may not feel like “networking”, the connections that you make with your peers are also invaluable. We have found that people on our course come from really diverse backgrounds and are at different stages in their careers. This makes for fascinating discussions in lectures and seminars because people can provide insights from their previous experiences working in different countries.

We hope these tips are useful and give you some ideas of extra-curricular opportunities that can work around and compliment your degree programme to help you make the most out of your time at UCL!

 

 

 

 

The benefits of a clinic visit: How I connected course learning, personal experience and observing a professional

e.schaessens24 April 2020

by Katie Gilchrist

I am an MSc Health Psychology student at UCL. As part of the programme, we are required to attend a clinic for observation. As a brain tumour survivor, a natural choice for me was the Neurosurgery clinic at The Unit of Functional Neurosurgery at The National Hospital for Neurology and Neurosurgery, London.

My sense of tumour

In December 2017 I was diagnosed with a benign brain tumour called acoustic neuroma and in February 2019 I underwent surgery at The Royal Randwick hospital in Sydney, Australia to have the tumour removed. A consequence of the surgery was being left with grade 6 House-Brackman facial paralysis, single sided deafness and one less vestibular nerve. I spent the first month recuperating from the surgery, practicing walking with one balance nerve and adjusting to losing the hearing in one ear and the loss of facial movement on one side of my face. Seven months after the surgery my husband and I packed up our lives after spending seven years in Australia and moved back to the UK where I started my MSc in Health Psychology at UCL. Following my experience, naturally, I was really excited about spending a morning in a hospital clinic (a mandatory part of the course) and even more excited when I saw there was a neuro clinic!

Feeling empathy for patients

So, recently I attended the clinic at The Unit of Functional Neurosurgery at The National Hospital for Neurology and Neurosurgery, London with Prof Ludvic Zrinzo. The clinic specialises in cranial nerve disorders such as hemifacial spasm (involuntary facial twitch) and trigeminal neuralgia (chronic facial pain). What I didn’t realise, when I made my selection, was that the conditions Prof Ludvic Zrinzo works with can present with facial droop or weakness and that for some of the conditions the surgical approach, risks and recovery are very similar to what I had. There were a lot of patients with facial movement issues and their faces looked like mine, asymmetrical smiles and one eye looking frozen open, foreheads not able to move and I felt such empathy for them. It was difficult not to run after them and comfort them but at the same time it was like hearing my own diagnosis over and over again. There were several moments where my eye (only one produces tears) glazed over and I had to concentrate not to show too much emotion as that would have been unprofessional. While it may help the patient to see we are human, it is not good for them to feel our burden which may accidentally transfer to them if we overshare.

Learning from the best

Having met a few surgeons through my own health experience, I was really blown away by Prof Ludvic Zrinzo’s approach to patient care. It was great to see a surgeon putting into practice all the psychology aspects we have learned in class this term; building rapport, explaining in clear language, allowing time for the patient to ask questions as well as all the additional points he covered like asking who was at home to help with care, reminding them to bring partners into appointments and explaining all the options available to them and really emphasising that it was the patients decision. Before each consultation, he explained to the patient who we were (there were three students observing) and he asked if it was ok if we stayed and listened. Only one patient decided at that time it was not ok for us to stay for that appointment and Prof Zrinzo kindly asked us to wait outside. On our return we didn’t ask about the patient and nor did he offer any information. The appointment had taken longer than some and we were playing catch up. I also felt there was an understanding between us that in this instance any discussion was to stay between patient and health professional.

What will I take from this into my future roles?

  1. The importance of asking the patient what they want
    • Did they mind having students in the room?
    • What were their thoughts on which treatment?
  1. The benefits of open dialog
    • Encouraging patients to include family and friends in the conversation
    • Explaining risks and benefits in layman’s terms without provoking fear
    • Asking about family, other health issues, home/work environment
    • Having open discussion with empathy and patience, even if it has been discussed several times previously

Overall, Prof Ludvic Zrinzo had such a great approach and I am so grateful to be able to have observed this. While it was emotional for me it really reaffirmed my desire to help people with health issues and I just wanted to say thank you to UCL and The National Hospital for Neurology and Neurosurgery for arranging such a great experience.

 

Being out at work

e.schaessens24 April 2020

An interview with Dr Julia Bailey by Sandra Medina and Angela Gichane (before the Covid-19 crisis)

Thank you for doing this interview with us.  Can you tell us about your job?

I am a sexual health doctor in South East London, and senior researcher in the eHealth Unit at UCL. I teach medical students, NHS staff and researchers, and am also a Graduate tutor and co-chair of the Equality Action Group.

What is your experience of being out at work?

I came out in 1987, when I was a medical student – 33 years ago! I’ve always been open about my sexuality (lesbian), but it doesn’t feel particularly relevant at work. I’ve never felt that that my sexuality was an issue working in primary care and in sexual health: these specialities tend to attract open-minded people, and I know of quite a few LGBQ (lesbian, gay, bisexual, queer) colleagues. Trans and Intersex people are less visible in academia and the NHS – we have a lot further to go in helping trans and intersex people feel seen, safe, welcome and included.

I haven’t experienced overt discrimination at work, but my sexuality has shaped (and limited) my choices. For example, I live in London to be part of the queer community, rather than risk feeling alienated in a small, conservative community.

Is visibility important?

A very important role model for me in my teens was the conductor of the Brighton Youth Orchestra (David Gray), who was a fantastically inspiring musician who was gay. His sexuality was well known, and there was no fuss about it (40 years ago).

At medical school there weren’t any visibly out members of staff, and no out students either – I found my community outside the medical school. I bumped into someone years later who told me that I had been an important role model for her at medical school, which was lovely to hear. As Dr Ronx (the queer, Black, androgynous A&E doctor) says, ‘You cannot be what you do not see’, and I think being visibly out is important.

How can tutors can support LGBTQIA* students?

It is really important that students can trust tutors, and that students feel able to talk about life beyond their studies (if they want to). I don’t proactively ask students about their personal lives, but I do tell them that I’m happy to discuss anything that affects their learning or wellbeing.

* LGBTQIA – lesbian, gay, bisexual, trans, queer, intersex, asexual/aromantic

Many people are quite confused about gender, sexuality, pronouns…. can you give us a summary?

Ah yes – I’ve written an e-learning module on this, and I train GP registrars and sexual health clinic staff. There is a lot of confusion, and concepts and language are changing over time …

Gender

In most societies worldwide people are seen as either ‘male’ or ‘female’ (i.e. binary categories).  These categories are decided (assigned) at birth, usually on the basis of genital appearance. A proportion of the population are intersex – i.e. their genetics, genitals and/or hormones are more complex than neat binary ‘male’ or ‘female’ categories.

Whilst sex and sex variation (male, female, intersex) are defined by genetics, gender identity is someone’s internal sense of gender (e.g. masculine, feminine, intersex, non-binary). Gender expression is the way that gender is expressed to others (e.g. through clothes, the body, behaviour…). Cis gender means that a person’s gender identity is the same as the gender they were assigned at birth (e.g. someone who was assumed to be female at birth, and who identifies as a woman). The terms Assigned Male at Birth (AMAB) and Assigned Female at Birth (AFAB) acknowledge someone’s gender history.

Non-binary or genderqueer people are those whose gender identity does not align with either ‘male’ or ‘female’, and who do not subscribe to conventional gender distinctions. Non-binary and genderqueer identities may be static or fluid. Some people may include aspects of ‘male’ and ‘female’ into their identities, others may reject binary gender categories entirely. Non-binary and genderqueer people may or may not look androgynous (not looking typically masculine or feminine).

Transgender or trans is a term for people who have a gender identity or gender expression that differs from their assigned gender. For example this could be someone who was assumed to be female at birth whose gender identity is male.

Pronouns (such as he, she, they) are very important in affirming someone’s gender identity.

Non-binary people may choose the pronoun ‘they’ as a gender neutral pronoun which is neither male nor female.  There are other gender neutral pronouns (e.g. ze, sie, hir, co, per, ey), and terminology concerning gender identity is evolving. It is important not to just guess or assume someone’s gender identity and pronouns.

Gender is distinct from sexuality. For example, ‘gay’, ‘lesbian’ or ‘bisexual’ are sexualities (sexual orientations), i.e. expressions of sexual attraction.  Gay men are typically attracted to male sexual partners; lesbians to female sexual partners; bisexual people are attracted to people of the same or different genders to them. LGBTQIA stands for Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual/Aromantic.  There are many, many other ways of expressing sexuality.

What would help trans and non-binary people feel welcome and included?

Getting people’s gender correct is really important, and it makes a huge difference to be asked rather than just guessing gender and pronouns (he, she, they) from someone’s appearance. This is especially important for trans and non-binary people, for whom mis-gendering can be relentless and horribly undermining.

My pronoun is ‘she’, but I also feel non-binary/genderqueer – I find it liberating to move away from the assumptions and expectations that go with being either male or female. It grates to be identified as a lady: e.g. “Good evening ladies and gentlemen…”. ‘Lady’ does not describe me, and it feels irrelevant and distracting – what does my gender have to do with being in a lecture, meeting, restaurant etc.? I feel that the assumptions and expectations of ‘men’ and ‘women’ can be profoundly harmful and limiting, and we should all be free to express ourselves however we like. We’re a long way from that vision, and expression can be especially hard for people who are marginalised in more than one way (e.g. trans women of colour). We have a lot of work to do to ensure that trans, non-binary and intersex people feel safe to be themselves at work.

As tutors and colleagues, we can demonstrate inclusive attitudes to gender and sexuality by displaying LGB, trans, non-binary and intersex stickers, badges or lanyards, and including logos and our own pronouns in email signatures for example.

For email footers:

Out@UCL logo which acknowledges people of colour and trans people:

How can we create a more inclusive workplace?

I think that social events are a good idea, to help people get to know each other. We need to check whether there barriers to being involved:

  • Equality. can everyone afford to come?
  • Diversity: is the invitation genuinely open to everyone?
  • Inclusion: are there factors that will exclude some people, such as alcohol, caring responsibilities, noise levels, access…..

‘Core competence’ in gender and sexuality is important, so that all staff are familiar with issues that LGBTQIA staff and students may face. It’s important to avoid assumptions, and check people’s preferences in terms of gender, pronouns, and confidentiality for example.

We need to avoid assuming heterosexuality, and avoid the gender binary – for example, ask say “Good afternoon everyone” instead of ‘Good afternoon ladies and gentlemen’. You can’t guess someone’s gender or sexuality by appearance, and there are far more LGBTQIA people than widely assumed.

Thank you, do you have anything more to add?

Thank you Angela and Sandra, it has been really interesting talking to you. It has reminded me how important these issues are!

Sources of support for LGBTQIA staff and students

Are some types of job bad for your mental health?

guest blogger17 January 2020

Mental illness is a major cause of early retirement – but do those who are forced to leave work early for this reason get better afterwards? What is the relationship between work stress and mental health? A new study of public sector workers in Finland suggests there is a link – and there are important lessons for employers. Tarani Chandola from the ESRC International Centre for Lifecourse Studies was among the authors of the study.

One way in which we can track the prevalence and level of mental illness is by looking at the use of psychotropic medication – that is, medication which can alter one’s mental state. This group of drugs includes common antidepressants, anti-anxiety drugs and antipsychotic medication. 

If there is a link between work stress and mental illness, then we should expect those forced to leave work for this reason to get better after retirement. So by tracking the levels of psychotropic medication among a group of workers before and after retirement, we could find out the extent to which there was such a link.

We were able to use data from a long-term study of Finnish public sector workers to examine the issue more closely. 

It matters because previous studies have shown an increase in the use of this group of drugs among all those who take disability retirement, particularly those whose retirement was due to mental ill health. Those from higher social classes saw the biggest drop in medication use after retirement, suggesting there are social factors at play here, too.

Global issues

The effect does seem to vary around the globe, though – some studies from Asia found an increase, rather than a decrease, in mental health problems after leaving work. But in Europe, retirement has often been found to be followed by an improvement in both mental and physical health. Retirees have reported sleeping better, feeling less tired and generally feeling a greater sense of wellbeing. 

We were able to use data from the Finnish Public Sector study cohort study, which followed all employees working in one of 10 towns and six hospital districts between 1991 and 2005. The study included participants from a wide range of occupations including administrative staff, cleaners, cleaners and doctors, and they were followed up at four-year intervals regardless of whether they were still in the same jobs. Their survey responses were linked to a register of medication purchases for at least two years before retirement and two years after.

We had information on 2,766 participants who took retirement because of disability. Uniquely, the data included both participants’ use of medication and their perceived levels of work stress. So we were able to ask whether there were differences in this pre and post-retirement effect between those in low and high-stress jobs.

Specifically, we looked at something called effort-reward imbalance – that is, when workers put in too much effort at work but get few rewards in compensation: according to a recent review, this carries an increased risk of depressive illness. 

If our theories were correct, we would see a decline in the use of psychotropic medication after disability retirement, and it would be greatest among those with high levels of effort-reward imbalance. Along with mental illness the other major cause of disability retirement in Finland is musculoskeletal disease, so we categorised our sample in three groups – mental illness, musculoskeletal disease and ‘other.’ Eight out of 10 in the sample were women, and three out of 10 reported high effort-reward imbalance before retirement.

Unsurprisingly, those who retired due to a mental disorder had the greatest increase in psychotropic drug use before retirement. And those who were in high-stress, low-reward jobs had higher levels of medication use than those who were not. But after retirement, there was no difference in psychotropic drug use between those with high vs low effort-reward imbalance. It looked as though stopping work in high stress jobs reduced the need for higher psychotropic medication use among those workers who exited the labour market for mental health reasons.  

Retirement because of musculoskeletal disease or other causes was not associated with any similar link between stress level and psychotropic medication.

Lessons for employers

Our study showed that among people retiring due to mental disorders, those in high-stress, low-reward jobs benefited most from retirement. So it’s likely that they could benefit from the alleviation of work-related stress before retirement, too.

In conclusion, if employers could find ways of reducing the levels of stress suffered by employees suffering from mental ill-health, their early exit from paid employment might be prevented and their working lives might be extended. 

Psychotropic medication before and after disability retirement by pre-retirement perceived work-related stress was published in the European Journal of Public Health, Vol. 0, No. 0, 1–6. 

The other authors were Jaana Halonen, Taina Leinonen, Ville Aalto, Tuula Oksanen, Mika Kivimäki and Tea Lallukka of the Finnish Institute of Occupational Health; Hugo Westerlund and Marianna Virtanen of the Stress Research Institute, Stockholm University; Martin Hyde of the Centre for Innovative Ageing, Swansea University; Jaana Pentti, Sari Stenholm and Jussi Vahtera of the Department of Public Health, University of Turku; Minna Mänty of the Department of Public Health, University of Helsinki; Mikko Laaksonen of the Research Department, Finnish Center for Pension.

These authors also have the following additional affiliations: Jaana Halonen; Stress Research Institute, Stockholm University; Jaana Pentti; Department of Public Health, University of Turku; Minna Mänty; Statistics and Research, City of Vantaa, Finland; Mika Kivimäki, Department of Public Health, University of Helsinki and Department of Epidemiology and Public Health, University College London; Marianna Virtanen, School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu; Tea Lallukka, Department of Public Health, University of Helsinki.

This blog article is courtesy of the Work Life blog, which is a blog about the relationship between work and  health and well-being of people, whether they are preparing for  working life, managing their work / life balance or preparing for retirement and life beyond retirement. Led by the ESRC International Centre for Lifecourse Studies, University College London

What makes an ideal Patient and Public involvement (PPI) panel?

guest blogger5 September 2019

Authors: Aradhna Kaushal, John Isitt, Christian von Wagner, Douglas Lewins and Stephen Duffy

The Policy Research Unit (PRU) in Cancer Awareness, Screening and Early Diagnosis recently set up a Research Advisory Panel to ensure that its research programme is relevant to and reflects the perspectives of patients and the public. In May, we ran a co-creation workshop designed to help the research advisory panel and PRU staff to build relationships with each other, to share ideas and experiences, to understand different perspectives, and to discover and prioritise discoveries together. The culmination of the workshop was the creation of a manifesto for the development of the Research Advisory Panel.

What did we do?

On the 31st of May we ran a co-creation workshop bringing together newly appointed patient and public members, with academics and administrators – to co-create the Research Advisory Panel’s (RAP) purpose, structure and culture to answer the challenge:

“What would the ideal Research Advisory Panel look like? What should it be responsible for? What’s the best way to involve PPI members effectively with academics and administrators? And how should it be organised?”

Co-creation in healthcare research, sometimes referred to as co-production, is “an approach in which researchers, practitioners and the public work together, sharing power and responsibility from the start to the end of the project, including the generation of knowledge” (NIHR, 2018). This approach is important in healthcare research as those affected by research are in an ideal position to contribute to the design and delivery of research through their unique experiences and knowledge.

The group was made up of nine patient and public involvement (PPI) members, four academic staff from the Policy Research Unit in Cancer Awareness, Screening and Early Diagnosis (PRU), the administrator who supports the PRU, and the PRU’s director. Everyone participated equally in the workshop to co-create what an ideal Research Advisory Panel for the PRU would be like and how best to support and integrate PPI members.

What did we find?

In the first half of the workshop, recognising the differences in experience and diversity of the group, attention was given to create relationships, safety, permission and tools for sharing our personal experiences of PPI – the good, the bad and the ugly – and identified a range of attributes and obstacles to PPI in research. We discussed the importance of developing good relationships between PPI members, researchers and clinicians, and creating a positive environment for us to work together.

“As a new PPI member, you’re thrust into the midst of academics, physicians, etc and expected to make conversation over coffee. This can be a big obstacle for some people. They can be totally phased by the social demands.”

“Researchers tend to operate in cliques outside the meeting. [We] need to identify training for researchers to approach us as well as us approaching them.”

“If it really is about being a tick box, now I walk away. I’m not going to be complicit with that kind of game play. If I’m in the room, then accept me being in the room. You might not like everything that I say and that’s allowed, but please don’t have me here as a hologram.”

We then worked in small groups to create the future, writing manifestos for the ideal RAP in terms of purpose, culture and structure, which we presented back to the workshop. The main proposals are summarised below.

What happens next?

The insights from this workshop will be used to guide the future working relationships of the research advisory panel of the PRU. We are currently adopting the manifesto into our current terms of reference and way of working. We also have exciting plans ahead setting up a training and development plan for PPI members and virtual space where they can keep in touch with each other.

For anyone interested in running a similar workshop, please contact Partners in Creation.

How to podcast

guest blogger30 July 2019

With the help of a Researcher-Led Initiative award, PhD students Fran Harkness and Jo Blodgett, and Research Fellow Aradhna Kaushal organised a day of podcast training for early career researchers to learn how to beam their findings straight into the ears of the general public. Here they explain what a podcast is and how you can get started making your own.

Why podcast?

Do you want to learn how to share your research discoveries beyond academic community (and pay-) walls? It would be unusual for a non-academic to read a journal, and as researchers, it’s not possible control how findings make headlines. But 6 million people in the UK listen to a podcast every week. And with people almost entirely listening to episodes as a lone activity- often on their phones whilst driving or travelling- the podcast has their full attention. Podcasts such as ‘All in the Mind’, ‘The Infinite Monkey Cage’, and our own Institute’s ‘The Lifecourse Podcast’ are easy to access (freely available online), and able to build a relationship with audiences through regular episodes. They disseminate new research in an informal style, often by chatting about new research with a fellow host, or interviewing academics.

Researcher-led initiative

We knew we wanted to make a podcast, but we didn’t know how. That’s where the Researcher-Led Initiative awards came in. We successfully applied for £1000 from the UCL Organisational Development to invite an experienced podcast trainer, Chris Garrington, and fellow academic and journalist Jen Allan to teach us everything we needed to make our own episodes.

Along with 13 other early career researchers, we learnt about the practical aspects of making a podcast such as how to conduct an interview, choosing recording equipment, incorporating jingles, editing audio files and disseminating podcasts online. We practiced recording and editing our recordings. It was such a buzz hearing our voices “introducing” our own podcast after the jingle. Of course 10, 000 more practice hours are needed before any Poddies are won but it was much easier than we thought it would be.

Recording a podcast series

We learnt that before you make your podcast, it’s important to consider the ideal format for the topic. For example, will a monologue or interview work best? Is the role of the presenter to ask questions on behalf of the audience or to offer their own opinions and thoughts? We also considered how many episodes are feasible to make, how often and how long should they be. Who are the audience and what kind of tone and style will appeal to them?

We experimented with sound quality between recording straight onto our laptops or enhancing it with different microphones, and received sage advice such as not to record in a coffee shop and to record some background sound separately when on you are on location in case you need to loop it in behind new recordings back in your studio (ahem bedroom). Jen then gave us a session of how to get the information you need from your interviewees, including to learn to soundlessly agree with them so to not cut them off (as qualitative researchers probably already know), and how to get around difficult questions.

What kit do you need?

You don’t need highly specialised equipment to make a podcast. An investment in a good microphone will ensure the quality of the audio recording. You may also consider different types of microphones (such as lapel microphones or hand-held) for different needs. You can also record interviews via Skype or Zoom using an Ecamm Call Recorder. Once you have your audio file, you can edit this using freely available software such as GarageBand (Mac) or Audacity (Windows). When you are ready to share your podcast with the world, you can share this using a podcast hosting website such as Libsyn: A podcast host simplifies and automates both the RSS feed and file hosting and delivery to your subscribers. But a good host does more than that by providing useful stats, tutorials, and support.

Thanks to Chris and Jen, we somehow finished the day with a mini episode and many big plans for the future! Watch this space.

Inclusion Health: Co-producing a research and advocacy agenda

guest blogger12 June 2019

Picture Credit: Ibrar Dar

Picture Credit: Ibrar Dar

Authors: Chantal Edge, Dr Binta Sultan, Serena Luchenski, Dr Al Story

There’s no avoiding the fact that health is getting worse for people who are at the extreme edges of society.  The number of people sleeping rough has almost doubled nationally.  Deaths among homeless people and people who use drugs are increasing, and we are putting more people in prison.   This is driven by social and political forces.  Over the last decade, austerity has led to record numbers of working families living in poverty and major increases in child poverty. Housing is unaffordable to millions, foodbanks have proliferated, children’s and youth centres have seen systematic disinvestment, and access to legal aid has been greatly reduced.  At the same time, funding is decreasing for services which reduce the harms of extreme social exclusion, such as addiction treatment, needle exchange and hostels.

So what should we, as a multidisciplinary research and advocacy group, be doing to stem the tide of inequity? How can we stop people from becoming socially excluded, improve services for people who are, and ultimately help people escape exclusion? The team at our newly launched UCL Collaborative Centre for Inclusion Health has reached out to experts with lived experience of exclusion, policy makers, voluntary sector, health and social care workers and academics to frame our research and advocacy priorities for the next five years.

So what is Inclusion Health?

“Inclusion Health is a service, research, and policy agenda that aims to prevent and redress health and social inequities among the most vulnerable and excluded populations.” (Luchenski 2017, The Lancet)

Put simply, Inclusion Health is about understanding the forces that cause and perpetuate social exclusion so we can prevent it and bring vulnerable and under-served people in our society ‘out of the cold’. People who are homeless, drug users, prisoners, or sex workers suffer from poorer health outcomes than people in the general population and are far more likely to die early.  Research at UCL found that women from these socially excluded groups were 12 times more likely to die than other women of the same age, and men eight times more likely. People who are socially excluded are more likely to be murdered or commit suicide and more likely to die from accidents, overdoses, infectious diseases, cancers, liver disease, heart problems and respiratory diseases. Social exclusion damages health, destroys lives and fractures communities. Dedicated research and advocacy to highlight the harms of exclusion and remedy the causes is urgently needed.

What is the new UCL Collaborative Centre for Inclusion Health?

The UCL Collaborative Centre for Inclusion Health (CCIH) was set up by a multidisciplinary team of researchers, experts with lived experience and frontline professionals who are dedicated to reducing health inequity. The Centre already has a broad range of research projects underway, measuring the health harms of exclusion and developing and testing interventions to improve the health of excluded groups. At the heart of all these projects are partnerships with people who have lived experience of exclusion (‘experts by experience’) and professionals from across the public and voluntary sector.

Co-producing the Inclusion Health agenda

Picture Credit: Ibrar Dar

Picture Credit: Ibrar Dar

On 3rd June 2019, the Centre held a launch event to bring together a wide range of experts to shape the agenda and co-produce research and advocacy priorities for the next five years.  Over 100 representatives from the voluntary sector, policy, academia, healthcare and a wide range of experts by experience worked together to tackle three key areas – preventing exclusion, improving services for those who are excluded and escaping exclusion.  Through a series of presentations, workshops, democratic voting and ‘dream-boarding’ we collected and collated information on where we need to start.

Consultation and analysis is on-going but emerging priorities include:

  • Tackling the upstream determinants of exclusion – political determinants, poverty and traumatic childhoods
  • Addressing societal and professional ignorance, indifference and stigma that can further deepen and perpetuate exclusion
  • Making services more accessible and integrated to stop people falling through the cracks
  • Ensuring that experts by experience are at the heart of health research, service development and decision making
  • Creating better routes out for people to escape exclusion

This event was run in partnership with the UCL Centre for Co-Production in Health Research and made possible by funding from UCL Grand Challenges.

Next steps

Over the coming months we’ll be disseminating our findings from the day. We will use this evidence to inform and influence research and advocacy priorities for funders, and ensure that our current and future research projects tackle the priorities that have been set.

There is a legal duty in England on politicians and policy makers to better integrate services and tackle health inequalities. People forced to the margins of our society suffer from humiliating disadvantage, preventable disease and premature death. Their lives, cut short, indicate that there is something toxic in our society. Evidence to inform better policy, practice and advocacy is urgently needed.

Picture Credit: Ibrar Dar

Picture Credit: Ibrar Dar

Chantal Edge is an NIHR Clinical Doctoral Research Fellow and Specialty Registrar in Public Health, researching the use of telemedicine for hospital appointments in prison. Dr Binta Sultan is an NIHR Doctoral Research Fellow and a Consultant in HIV and Sexual Health, her research centres on improving hepatitis C linkage to care in people who experience homelessness using novel technologies. Serena Luchenski is an NIHR Clinical Doctoral Research Fellow, a Consultant in Public Health and Chair of the UCL Collaborative Centre for Inclusion Health; her research is on developing a public health preventative approach to hospital care for people experiencing homelessness. Dr Al Story leads the Find&Treat Outreach Service based at UCLH and is Co-Director of the UCL Collaborative Centre for Inclusion Health.

Picture-credit-Binta-Sultan

Picture-credit-Binta-Sultan

If you’re interested in learning more about Inclusion Health we run a short course on Homeless and Inclusion Health at UCL. This can also be taken as an optional MSc module on the MSc Population Health or any UCL MSc programme. It has no pre-requisites and we welcome interested participants from any sector. You can find more information here.

If you are interested in becoming involved in Inclusion Health research please contact us at ccihcore@live.ucl.ac.uk outlining your area of interest.

Accessing GP appointments- a disaster waiting to happen or hope on the horizon?

guest blogger17 May 2019

In this post Ruth Abrams and Sophie Park reflect on the current pressures facing GPs and NHS today.

In a recent expose called ‘GPs: Why Can’t I Get an Appointment?’, a Panorama documentary, which aired on BBC1 on Wednesday 8th May, emphasised the current limits of and pressures on the NHS system. The programme featured interviews with overworked GPs and allied healthcare professionals, painting a rather bleak picture. Practices are merging and closing at an ever increasing rate. Patient loads increase as patient lists are subsumed. Patient multi-morbidities have increased the need for chronic conditions to be monitored with regular GP appointments. Yet on average patients wait a minimum of two weeks for a routine appointment. Early retirement and a limited flow of trainees into General Practice also contribute to the strain, making practice sustainability difficult to envisage. Inevitably, pressure and frustration are being felt amongst both patient groups and the primary care workforce.

Whilst those researching, working in and experiencing primary care within the UK will already be familiar with these factors, what has become a pressing concern since the 2015 publication of the BMA’s, National survey of GPs: The future of General Practice, is patient safety. At present only the most urgent of cases are seen quickly in General Practice. Yet still an unsafe number of patients are seen by any one GP in a day. This high demand placed upon GPs makes for little time to reflect on cases.

Enter- the release of the new GP contract and the NHS long term plan which intend to employ a multi-disciplinary army of healthcare professionals. Within this new way of working, workloads will be shared amongst staff, with greater efforts being made for both integration and collaboration. A typical GP’s day will begin to look very different. Micro-teams will have time to discuss patient cases, a GP’s time can once again be focused on the professional tasks only they can undertake and overall there begins to be a healthier outlook to teamwork.

Some promote this utopian vision of General Practice working unquestioningly. Pots of money, such as those made available through the Prime Minister’s Fund, have encouraged new ways of working with very limited evidence base. Yet one aspect seemingly unaddressed within the new plans is the disparity across patient access and levels of deprivation within the UK. In a recent report by the Health Foundation, GPs working in higher deprived areas see more patients compared to their counterparts. These are areas where recruitment of this new workforce will inevitably be harder. This raises questions about how best to incentivise recruitment so that patient access to care remains equal for all.

There is also a certain feel that these plans are being done to, rather than with GPs. We need only reflect back a few short years to the junior doctor protests to recall that in order for patient safety to happen, workforce perspectives must be accounted for. In order for the NHS to remain as successful as it has been and for the principles of Astana declaration to be realised, GP engagement rather than negation needs to remain central to all future planning activities.

Unequal access to care and a disruption to professional identities present major issues. But doing nothing is no longer an option. At a time when the NHS is so often synonymous with the words crisis and strain rather than success, a Utopian vision for both staff and patients may be both timely and necessary. Reifying this however, becomes a different matter all together.

Retirement: good or bad for your heart?

guest blogger16 May 2019

Is retirement good for your heart, or bad for it? The question is an important one because cardio-vascular disease (CVD) is the biggest cause of death globally and costs health services a huge amount of money.

Some studies have shown retired people have a higher risk of being diagnosed with CVD than those who are still working. But until now the evidence has been unclear.

We set out to review evidence from across the world, so that we could help to build a more accurate picture of whether, and how, retirement might affect our cardio-vascular health. As CVD is linked to our lifestyle, diet and other behaviour, there are lots of ways in which changes that take place in retirement might have an effect – both negative or positive.

Longitudinal studies

We looked for longitudinal studies that could help answer our questions, and found 82 which measured risk factors for CVD and 14 which looked at actual incidence of CVD. The second set of 14 papers provided the answer to our first question – does retirement affect our cardio-vascular health?

The answer revealed a major difference between the USA and Europe. Studies conducted in the US showed no significant effect, good or bad, on retirees’ cardio-vascular health. In Europe, meanwhile – with the exception of France – studies consistently showed a link between retirement and an increase in CVD.

Data from the British Regional Heart Study, for instance, showed that healthy men who retired before the age of 60 were more likely than others to die from circulatory disease within five and a half years. Fatal and non-fatal CVD was also more common among retirees in Denmark, Greece, Italy and the Netherlands.

Why might this be? Could there be cultural or lifestyle differences between Europe and the US which might cause this difference? We took a systematic look at the risk factors.

Weight gain

First, we looked at weight gain. If Americans were less likely to put on weight after retirement compared to Europeans, that might help to explain the difference. But when we looked at this, we found that body mass index (BMI) actually increased after retirement in the USA – and also Japan -but did not change in England, Denmark, France, Germany, Switzerland or Korea. While those who do physically demanding jobs are likely to put on weight after they retire, most people aren’t.

Could it be that retired people generally do less exercise – another risk factor – in Europe? The studies suggest that’s not the reason. While many retirees did more physical activities, they also spent more time sitting still – so the effect was a balanced one. For instance, a retiree might play more golf, but also watch more television.

Do retired people perhaps smoke more, we asked? Again, there were contradictory results but 12 out of 14 studies either showed no effect or showed retirement led to people smoking less.

Perhaps retired people in Europe drink more, then? Again, this couldn’t be identified as the reason. Studies in Australia, the UK, Japan and the USA suggested there was no association between retirement and alcohol consumption.

Diet is another possible cause of CVD, but again, there was no clear pattern of between retirement and diet emerged from reviewed studies.

No benefits

So the picture isn’t straightforward, and we don’t have answers as to why retirement might put Europeans at risk but not Americans. What we can say, though, is that none of the studies we looked at found any beneficial effects of retirement on CVD.

Apart from a decrease in smoking, there wasn’t evidence of any general ‘relief’ effect of retirement on people’s cardio-vascular health – so the supposition that working could be bad for our health and therefore retirement better for it doesn’t necessarily hold true.

However, studies that showed retirement brought negative health effects should be interpreted with caution. Many assessed the health effects of retirement by comparing retired people with employed people – and we know people who stay in the labour market are generally healthier than retirees. We do know people who have CVD, diabetes or hypertension are more likely to retire.

What our review has done is to reveal the complex nature of the underlying mechanism through which retirement might impact on the risk factors for CVD. Different people react differently to retirement, depending on their life experiences and the cultural and policy environments in which they live. So there isn’t one global solution to any of this – each country needs to plan its citizens’ retirement according to their individual needs.

The impact of retirement on cardiovascular disease and its risk factors: A systematic review of longitudinal studiesby Baowen Xue, Jenny Head and Anne McMunn, is published by The Gerontologist.

This blog article is courtesy of the Work Life blog, which is a blog about the relationship between work and  health and well-being of people, whether they are preparing for  working life, managing their work / life balance or preparing for retirement and life beyond retirement. Led by the ESRC International Centre for Lifecourse Studies, University College London,

guest blogger24 April 2019

Where you live in your 20s affects when you retire – here’s how

File 20190417 139116 1aozy2a.jpg?ixlib=rb 1.1
Where you decide to live will impact your career. Shutterstock.

Emily Murray, UCL

Across the globe, people are living longer. Many countries – including the UK – have responded by raising the age of retirement. By 2028, UK citizens will need to be 67 years old to receive their state pension, and further increases have been recommended by both government and independent reviews.

But there’s one major issue with this: most employees in the UK already stop working before the current state pension age of 65. For some, early retirement can be a positive life change which means they can afford to stop working. But for others, early retirement is a result of poor health or unemployment, which can eat into savings and widen inequalities among older people.

Previous studies have shown that in areas where there are more unemployed people, older people are also more likely to leave the workforce. In the past, researchers thought this was because older workers are more likely to be made redundant and have a harder time finding another job when they are unemployed.


Read more: Where people live influences whether they stop working before pension age


But our new research shows that the link between local unemployment and retirement age actually depends on where people live as young adults. Specifically, people in their 20s who live in areas where there are fewer jobs are more likely to be unemployed and in poor health at mid-life – and these are two significant causes of early retirement.

A lifelong study

My colleagues and I at the Research on Extended Working Lives (RenEWL) consortium set out to understand this phenomenon using data from the 1946 British birth cohort study – a representative sample of all British people born in one week in March 1946 across England, Scotland and Wales.

There were 2,526 cohort members, who told us whether they had retired from their main occupation or were still in work. First, we explored where they had lived in childhood (at age four), young adulthood (age 26) and mid-life (age 53). Then, for all three ages, we looked at census data to find out how many working-age people in their local authority were unemployed at the time.

History matters. Shutterstock.

By the age of 68, more than 80% of the people in the cohort had retired, with the average age of retirement being around 59 years. As seen in previous studies, those who lived in areas with higher levels of unemployment at mid-life, also tended to retire earlier. For each 5% increase in local unemployment, people retired on average roughly 1.5 years earlier.

Long-term effects

But when we started to delve into where cohort members had lived earlier in their lives – as well as considering their health, employment and education history – we realised just how strongly unemployment levels in the local area during early adulthood continued to affect people throughout their lives.

If a cohort member lived in a local authority where there was more unemployment than average as a child, it was also likely that they would live somewhere similar as an adult. And those who lived in areas with higher than average unemployment rates as young adults then went on to have poorer health and were more likely to be unemployed at mid-life – compared with those who lived in areas with lower unemployment rates.

Researchers have found that health and employment status strongly predict what age people retire. We found this as well, with cohort members who were unemployed at mid-life retiring on average about five years earlier than those who were working full time at the same age.

What’s more, we found that the link between where people live in their mid-life and their retirement age can actually be traced right back to where they lived in their 20s. So the experiences people had when they were younger had a long term impact on their health and employment status at mid-life.

For example, someone who had moved in their early 20s to Guildford, where there was high employment, was more likely to still be in work when they reached mid-life, than someone who had lived in their 20s in Glasgow – where unemployment was high – regardless of where either lived later in life (although it is likely both will have lived in the same or equivalent employment area in their 50s).

Our findings imply that people should think carefully about how where they live⁠ ⁠might affect⁠ ⁠t⁠h⁠e⁠i⁠r⁠ ⁠c⁠a⁠r⁠e⁠e⁠r⁠.⁠ ⁠P⁠e⁠o⁠p⁠l⁠e⁠ ⁠seem to k⁠n⁠o⁠w⁠ ⁠t⁠h⁠a⁠t⁠ ⁠i⁠t⁠’⁠s⁠ ⁠e⁠a⁠s⁠i⁠e⁠r⁠ ⁠t⁠o⁠ ⁠g⁠e⁠t⁠ ⁠a⁠ ⁠j⁠o⁠b⁠ ⁠i⁠n⁠ ⁠a⁠r⁠e⁠a⁠s⁠ ⁠where there are more jobs available – indeed, graduates tend to migrate into urban centres with more employment opportunities. ⁠O⁠u⁠r⁠ ⁠r⁠e⁠s⁠e⁠a⁠r⁠c⁠h⁠ ⁠s⁠h⁠o⁠w⁠s⁠ ⁠t⁠h⁠a⁠t⁠ ⁠t⁠h⁠e⁠s⁠e⁠ ⁠e⁠a⁠r⁠l⁠y⁠ ⁠c⁠a⁠r⁠e⁠e⁠r⁠ ⁠d⁠e⁠c⁠i⁠s⁠i⁠o⁠n⁠s⁠ ⁠c⁠a⁠n⁠ ⁠h⁠a⁠v⁠e⁠ ⁠c⁠o⁠n⁠s⁠e⁠q⁠u⁠e⁠n⁠c⁠e⁠s⁠ ⁠i⁠n⁠t⁠o⁠ ⁠p⁠e⁠o⁠p⁠l⁠e⁠’⁠s⁠ ⁠r⁠e⁠t⁠i⁠r⁠e⁠m⁠e⁠n⁠t⁠ ⁠y⁠e⁠a⁠r⁠s⁠.

If the government wants to encourage people to stay in work longer, it should give older workers the support they need to stay in work and in good health. It could also help them maintain their employment, even when they’re not in the best of health – for example by adapting workplaces for older workers, or encouraging flexible working. By improving job opportunities for young people living in places with high unemployment, it could help people to keep working for

Where you live in your 20s affects when you retire – here’s how

File 20190417 139116 1aozy2a.jpg?ixlib=rb 1.1
Where you decide to live will impact your career. Shutterstock.

Emily Murray, UCL

Across the globe, people are living longer. Many countries – including the UK – have responded by raising the age of retirement. By 2028, UK citizens will need to be 67 years old to receive their state pension, and further increases have been recommended by both government and independent reviews.

But there’s one major issue with this: most employees in the UK already stop working before the current state pension age of 65. For some, early retirement can be a positive life change which means they can afford to stop working. But for others, early retirement is a result of poor health or unemployment, which can eat into savings and widen inequalities among older people.

Previous studies have shown that in areas where there are more unemployed people, older people are also more likely to leave the workforce. In the past, researchers thought this was because older workers are more likely to be made redundant and have a harder time finding another job when they are unemployed.


Read more: Where people live influences whether they stop working before pension age


But our new research shows that the link between local unemployment and retirement age actually depends on where people live as young adults. Specifically, people in their 20s who live in areas where there are fewer jobs are more likely to be unemployed and in poor health at mid-life – and these are two significant causes of early retirement.

A lifelong study

My colleagues and I at the Research on Extended Working Lives (RenEWL) consortium set out to understand this phenomenon using data from the 1946 British birth cohort study – a representative sample of all British people born in one week in March 1946 across England, Scotland and Wales.

There were 2,526 cohort members, who told us whether they had retired from their main occupation or were still in work. First, we explored where they had lived in childhood (at age four), young adulthood (age 26) and mid-life (age 53). Then, for all three ages, we looked at census data to find out how many working-age people in their local authority were unemployed at the time.

History matters. Shutterstock.

By the age of 68, more than 80% of the people in the cohort had retired, with the average age of retirement being around 59 years. As seen in previous studies, those who lived in areas with higher levels of unemployment at mid-life, also tended to retire earlier. For each 5% increase in local unemployment, people retired on average roughly 1.5 years earlier.

Long-term effects

But when we started to delve into where cohort members had lived earlier in their lives – as well as considering their health, employment and education history – we realised just how strongly unemployment levels in the local area during early adulthood continued to affect people throughout their lives.

If a cohort member lived in a local authority where there was more unemployment than average as a child, it was also likely that they would live somewhere similar as an adult. And those who lived in areas with higher than average unemployment rates as young adults then went on to have poorer health and were more likely to be unemployed at mid-life – compared with those who lived in areas with lower unemployment rates.

Researchers have found that health and employment status strongly predict what age people retire. We found this as well, with cohort members who were unemployed at mid-life retiring on average about five years earlier than those who were working full time at the same age.

What’s more, we found that the link between where people live in their mid-life and their retirement age can actually be traced right back to where they lived in their 20s. So the experiences people had when they were younger had a long term impact on their health and employment status at mid-life.

For example, someone who had moved in their early 20s to Guildford, where there was high employment, was more likely to still be in work when they reached mid-life, than someone who had lived in their 20s in Glasgow – where unemployment was high – regardless of where either lived later in life (although it is likely both will have lived in the same or equivalent employment area in their 50s).

Our findings imply that people should think carefully about how where they live⁠ ⁠might affect⁠ ⁠t⁠h⁠e⁠i⁠r⁠ ⁠c⁠a⁠r⁠e⁠e⁠r⁠.⁠ ⁠P⁠e⁠o⁠p⁠l⁠e⁠ ⁠seem to k⁠n⁠o⁠w⁠ ⁠t⁠h⁠a⁠t⁠ ⁠i⁠t⁠’⁠s⁠ ⁠e⁠a⁠s⁠i⁠e⁠r⁠ ⁠t⁠o⁠ ⁠g⁠e⁠t⁠ ⁠a⁠ ⁠j⁠o⁠b⁠ ⁠i⁠n⁠ ⁠a⁠r⁠e⁠a⁠s⁠ ⁠where there are more jobs available – indeed, graduates tend to migrate into urban centres with more employment opportunities. ⁠O⁠u⁠r⁠ ⁠r⁠e⁠s⁠e⁠a⁠r⁠c⁠h⁠ ⁠s⁠h⁠o⁠w⁠s⁠ ⁠t⁠h⁠a⁠t⁠ ⁠t⁠h⁠e⁠s⁠e⁠ ⁠e⁠a⁠r⁠l⁠y⁠ ⁠c⁠a⁠r⁠e⁠e⁠r⁠ ⁠d⁠e⁠c⁠i⁠s⁠i⁠o⁠n⁠s⁠ ⁠c⁠a⁠n⁠ ⁠h⁠a⁠v⁠e⁠ ⁠c⁠o⁠n⁠s⁠e⁠q⁠u⁠e⁠n⁠c⁠e⁠s⁠ ⁠i⁠n⁠t⁠o⁠ ⁠p⁠e⁠o⁠p⁠l⁠e⁠’⁠s⁠ ⁠r⁠e⁠t⁠i⁠r⁠e⁠m⁠e⁠n⁠t⁠ ⁠y⁠e⁠a⁠r⁠s⁠.

If the government wants to encourage people to stay in work longer, it should give older workers the support they need to stay in work and in good health. It could also help them maintain their employment, even when they’re not in the best of health – for example by adapting workplaces for older workers, or encouraging flexible working. By improving job opportunities for young people living in places with high unemployment, it could help people to keep working for longer.The Conversation

Emily Murray, Senior Research Fellow, Department of Epidemiology & Public Health, UCL

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Emily Murray, Senior Research Fellow, Department of Epidemiology & Public Health, UCL

This article is republished from The Conversation under a Creative Commons license. Read the original article.