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“Why am I doing this?!” A reminder.

NathanDavies6 September 2018

I have been assured that asking oneself “Why am I doing this?!” is not an experience unique to any one stage of a research career. The key is having a good answer.

At the height of the British summer heat wave, I travelled to Chicago, to give an oral presentation to the Alzheimer’s Association International Conference (AAIC) on a project I’ve joined, funded by the Dunhill Medical Trust, addressing inequality in primary care of people with dementia among UK ethnic groups.

The first phase of the project has already been published in Clinical Epidemiology and found that dementia diagnosis incidence was significantly higher in Black men and women compared to White men and women, respectively, and was significantly lower in Asian women compared to White women. Tra recently wrote a blog on this below. I presented these results along with new results showing inequality by ethnicity in prescribing of certain drugs among patients with dementia.

The presentation itself went smoothly, and I breathed a sigh of relief as I walked off stage. With the nerves and the bright lights out of the way, I was excited to find that a queue of people were keen to talk with me about the project.

Multiple researchers expressed how grateful they were that someone was looking into this area, highlighting that while the demographics of many developed nations are changing, the research has not often kept up. Others wanted to share personal experiences, speaking of the reluctance of family members to seek a diagnosis or medication even as their condition progressed, especially when cultural factors around memory problems and fear of stigma were at play. These conversations made clear that the need to identify inequalities and break down barriers to good quality care was not a problem unique to the UK, but everyone I spoke with reinforced how important it was to see that we’re working on it.

In the midst of Stata code, funding applications, and reviewer comments, we can lose sight of the goal. As researchers, we have the privilege of generating work that can improve peoples’ lives. We can be reminded of that by our Patient & Public Involvement advisors, our colleagues, or a review of the “Impact” section of our own funding application (and hopefully by this blog post). My conversations with a variety of people after my presentation was a wonderful reminder of the goal and impact of this project. I hope you can take a moment today to remember the goal of your work too, because you’re doing this for a good reason!

HPRU in Blood Borne and Sexually Transmitted Infections

NathanDavies5 April 2017

In this post Tom Hartney, a PhD student at PCPH, talks about the Health Protection Research Unit and its recent Academy day.

The Health Protection Research Unit (HPRU) is a collaboration between universities, including University College London and Imperial College London, and Public Health England (PHE). This is part-funded by the National Institute of Health Research (NIHR) in order to promote high quality multi-disciplinary health research. It was set up in 2012, and supports the funding of PhD students to work on projects related to the HPRU’s research objectives.

These students make up the HPRU Academy – this isn’t a university in itself, but instead represents PhD students based across several universities, working in 10 research units each of which focuses on a different health issue (such as emerging infections or environmental hazards) or methodology (such as modelling or evaluation of interventions). This January saw the first HPRU Academy Retreat, which brought together students from across the country to present results from their work and hear about future plans and priorities for the Academy.

T Hartney April 17

Me, second left, and Josina, third left, at the Academy Retreat with our fellow PhD students from the HPRU in Blood Borne and Sexually Transmitted Infections

Myself and Josina Calliste from PCPH attended, both representing the HPRU in Blood Borne and Sexually Transmitted Infections. With 19 students giving oral presentations, as well as talks from academics and PHE staff, over two days, we knew this would be a packed schedule, but it gave us a chance to meet other students working on public health topics, to talk about our projects and find opportunities to work with them in future.

The format was divided into two types of talks, with those from students talking about their work making up the majority of the programme, and each day introduced and ending with talks from HPRU academics on the public health research landscape and aspects of methodology. The student presentations covered a huge breadth of healthcare topics, from the effects of traffic pollution to the risks from ticks in urban areas, with the research opportunities provided by genomic sequencing being a common theme. Given there was so much to cover, students somehow still managed to convey their enthusiasm for their chosen topic and explain their key results while sticking to time.

Professor Bernie Hannigan gave the PHE perspective on the Academy, emphasising its focus on applied research – identifying gaps in the evidence and addressing them with research outputs – as well as the need for researchers to think about how evidence influences public health policy & practice. Dr Satnam Sagoo, PHE’s Head of Education and Training, discussed routes to develop a career in public health, setting out the options available and ways to enhance transferable skills during the PhD process.

Karen Wilding from the University of Liverpool presented on research ethics and governance, a fundamental aspect of every research project. She described the variety of clinical research governance systems and frameworks, as well as the key considerations for ethics, and resources available for help and advice. Finally, Professor Jackie Cassell from Brighton and Sussex Medical School talked about getting patients and the public involved in research. She described ways to implement this at every stage of the lifespan of the doctorate, some of the challenges involved in healthcare research in general, and on transient and stigmatised conditions in particular. Imaginative approaches to public engagement were illustrated  these using the example of an exhibition on scabies at the Eastbridge Hospital in Canterbury – originally a medieval hospital for pilgrims – set up in collaboration with the Textile Department of the University of Brighton.

To break things up the Retreat included interactive elements – firstly, in the form of an outbreak response exercise led by Dr Ruth Ruggles, Head of Public Health Training at PHE. Dr Ruggles used data from a real outbreak to put students in the role of public health response teams with crucial decisions to make as the outbreak developed. This culminated in a role played press conference, with volunteers fielding tricky questions from the audience on the media and public reaction to the outbreak. Also, students were able to vote online on their favourite talks and poster presentations, with prizes awarded by Professor Tom Solomon from the University of Liverpool on the final day.

Despite the challenge of packing so much into a two day schedule, the inaugural HPRU Academy retreat provided plenty of food for thought on how to use the expertise available within the Academy – here’s looking forward to next year’s event.

Academic Primary Care – Not sinking, nor swimming, but motoring!

NathanDavies14 March 2016

This month Rammya Mathew an Academic Clinical Fellow from the Centre for Ageing Population Studies talks about her first and very impressive first time at the SAPC regional Madingley conference which this year we hosted.madingley

This was my first experience of SAPC, and what a fantastic introduction it was. The conference was jam-packed with inspirational speakers, some of whom have paved the way for academic primary care, and many more who look set to be future leaders within the field. The question posed to us by the chair, Professor Elizabeth Murray, was ‘InnovatioEM madingleyn in a sea of change – will academic primary care sink or swim?’. However, the overwhelming attendance and the enthusiasm among delegates spoke volumes in itself, and provided a sound evidence base for the conclusion, which I will share later.

 

The opening keynote speech by Professor Martin Marshall challenged our views of traditional research. The need to bridge the gap between the knowledge base that academia provides, and what actually happens in clinical practice was brought to our attention. He introduced the concept of participatory research, and by sharing his own experiences of being an embedded researcher in East London, he demonstrated the impact that this model may have in terms of knowledge creation and mobilisation.

The ‘Dragon’s Den’ was an exciting new addition this year. For some reason, our esteemed judges got slightly confused and enacted the ‘Strictly come dancing’ panel instead. But we had to forgive their mishap, as their sense of humour more than compensated for the error. The calibre of the candidates that were pitching was truly remarkable. Dr Kingshuk Pal from UCL propositioned HELP DIABETES – a fully-fledged online website that supports self management of diabetes. KP MadingleyHowever, the dragons were fierce in expressing their concern that HELP DIABETES would be another tool best suited to those who are already self motivated. The second pitch was by the medical education department at Imperial College London, who were asking for all medi
cal students to go to jail! madingley prisonThey put forward a passionate argument that this would improve their understanding of health inequalities and provide experiential learning of working with marginalised groups. This was a moving presentation that tugged at the heart strings of the audience, but the dragons questioned what would be removed from the curriculum in order to make way for this initiative. The last and final pitch was an online pathway, which offered advice, testing and treatment for chlamydia. Being practical and having demonstrated proof of success, it sealed the deal. madingley clam

One of the things that stood out to me from the presentations at SAPC this year, was that the conference clearly demonstrated the excellent insights that well-conducted qualitative research can offer. A particular presentation which highlighted this was by, Dr Nadia LLanwarne from Cambridge. She presented the findings of her research, exploring the missed opportunities for diagnosing melanoma in primary care and the patient experience along this journey from initial presentation to diagnosis. I certainly came away from the conference this year, feeling assured that qualitative research is both valuable and necessary – its role was cemented, in terms of putting quantitative research into context and relating it to the real and often ‘messy’ world we face in general practice.

Professor Roger Jones, editor of the BJGP, rounded up the conference with an excellent plenary session. Using his personal story, he talked about the degree of change we have seen in primary care over the years –  across academia, education and clinical practice. It was a real eye-opener! It was encouraging to hear the he still looks forward to going to work everyday and has maintained his enthusiasm for general practice, despite the ever changing working environment. Finally, the conference came to a close and we unanimously concluded that academic primary care was not sinking, nor swimming, but was indeed motoring!

madingley trials madingley care planning madingley ucl

Dr Sophie Park recognised for her contribution to Educational Research in Primary Care

NathanDavies13 July 2015

Dr Sophie Park, GP & Senior Lecturer in Primary Care at UCL, was highly commended for the Yvonne Carter Award 2015 for her innovative work in developing a distinct body of educational research in primary care.

Below Joanne Reeves, Amanda Howe and Sophie Park on Thursday 10th July in Oxford at the SAPC ASM.

 

SOPHIE PARK AWARD

Students get skilled at Cumberland Lodge conference

NathanDavies25 July 2014

cumberland lodge

Ann Liljas talks about her experience of attending a graduate student conference at Cumberland Lodge.

Every year around 30 graduate students in the public health field are invited to a conference at Cumberland Lodge in Windsor Park. This 3-day conference is organised for students by students to provide the opportunity to gain skills within various fields of health research, share ideas and get to know each other. Cumberland Lodge is part of the King George VI and Queen Elizabeth Foundation of St Catherine’s which was set up to provide a sympathetic ambience for students and their lecturers to develop and explore their studies, free of the pressures of time or assessment.

This year’s conference took place between 30 May to 1 June and the theme was Major Public Health Challenges Facing the UK. Three students from Primary Care and Population Health attended; Rosa Lau, Kethakie  Sumathipala and Ann Liljas. There were six sessions on a number of public health topics ranging from depression, cardiovascular disease and dementia to obesity, diabetes and cancer. Each session was delivered by an expert in the field from either UCL or another university in London. The speakers started by providing some background information on their particular topic and why it is an important public health issue. They then moved on to demonstrate what research has been done and what needs to be done to improve that particular health issue.

The conference really provided an opportunity to learn more about various public health issues and an opportunity for networking. Top 3 discussions at the conference included the associated between appetite and increased risk of obesity, why aspirin can reduced the risk of cancer, and the importance of considering other morbidities in people who already have a disease. If you want to find out more about these particular topics, take a look at the papers listed below which are based on studies undertaken by some of the presenters.

Llewellyn, C et al. 2010 Nature of nurture in infant appetite: analysis of the Gemini twin birth cohort. American Journal of Clinical Nutrition. 91(5):1172-1179 Access

Rothwell, PM et al. 2011 Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials. The Lancet. 377(9759):31-41 Access

Haddad, M et al. 2013 Detecting depression in patients with coronary heart disease: a diagnostic evaluation of the PHQ-9 and HADS-D in primary care, findings from the UPBEAT-UK study. PLoS One. 10;8(10):e78493 Access