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  • Oct 28 / 2015
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Making the most of clinical research networks

Photo by Daria Shevtsova ©. Unsplash. Used with permission.


By Siobhán O’Connor

For those public health researchers with a specific clinical background, tapping into a local and national network of clinical researchers can make a huge difference in terms of how your research progresses and opportunities for a long-term research career. Continue Reading

  • Aug 14 / 2015
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Academia, PhD Experience, Ruth Agbakoba

…it’s nice to see you, to see you nice! How to get the best out of a world congress

Photo by Korean Culture and Information Service © 2010. UNESCO WCAE. From Wikimedia Commons.

Photo by Korean Culture and Information Service © 2010. UNESCO WCAE. From Wikimedia Commons.

By Ruth Agbakoba

You may be thinking that this week’s blog post is a tribute to Sir Bruce Forsyth or a reminder of the classic TV show ‘play your cards right’! I know!! L “Come on down” Unfortunately and I’m sorry to disappoint you but it is not entirely. Hopefully I have succeeded in getting your attention though! In my previous post I talked about my ‘five top tips for writing a conference paper’. Now your paper has been accepted (congratulations!) and you are due to attend this amazing conference! What do you do next? Well the purpose of this post is to really highlight and capture how best to participate and gain the most value from a research conference in particular a World Congress. Continue Reading

  • Jul 16 / 2015
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On sharpening knives, stigma and mental health

By Tiago C. Zortea:

Ten years ago, in the second year of my undergraduate course in Psychology, I came across a short book chapter that caused me to rethink many of the ways in which I understood mental health: The actress, the priest, and the psychoanalyst: The knife sharpeners, written by the Brazilian Professor of Social Psychology Luis Antonio Baptista [1]. Baptista uses the examples of an actress, a priest and a psychoanalyst to explore how ‘public opinion makers’ can indirectly contribute to intolerance and violence against those who they do not consider ‘standard’, ‘holy’ or ‘normal’ respectively. According to the author’s metaphor, they are not directly involved in these people’s death, but they ‘sharpen the knives of the crimes’.

Since then, I have asked myself many times whether I am a ‘knife sharpener’. Do the things I do and say, in some sense, contribute to excluding people from society? Am I categorising people into personality profiles or groups of symptoms that mean they identify themselves as being either ‘normal’ or ‘pathological’? What kind of approach do I take towards mental health and what are the consequences of this approach in people’s lives? The more I study, the more concerns I have about the implications of my words on people, especially on the general public. Diagnosis criteria can be easily misunderstood, particularly when the topic is mental health. It is critically important to be careful when talking about psychiatric diagnosis in a public forum (e.g., on television, at public engagement events). It is from misunderstandings and insensitive perspectives on mental health that popular and stigmatising notions of ‘normal’ and ‘pathological’ are born. In 2014, Professor Peter Kinderman, President-Elect of the British Psychological Society published a fantastic book entitled “A prescription for psychiatry: Why we need a whole new approach to mental health and wellbeing” [2]. Among several issues regarding mental health, Kinderman alerts us to how problematic certain labelling practices can be and suggests we should stop dealing with “people’s distress as merely the symptom of diagnosable illness and instead develop a more appropriate system for describing and defining people’s emotional problems” (p. 48).

Baptista [1] examines how stigma can be reinforced not only by specialists but also celebrities and certain conservative religious institutions. It is important to remember that until the 1970s, homosexuality was listed as a mental disorder in the DSM (Diagnostic and Statistical Manual of Mental Disorders) classification [3], and several religious institutes based their arguments on DSM to state how each gender should behave and to to justify their position that same sex relationships were abnormal and unnatural.

On the 17th of April 2015, BBC Panorama showed a documentary entitled “A Suicide in the Family” [4] and one of the interviewees, Matt – a young man who tried to end his own life – said: “I’ve always been a quite expressive person, if you like… I’ve been sort of, quite effeminate maybe? It did not really fit in with my group of friends, sort of things. I always felt like an outsider looking in. That was obviously difficult because when you’re growing up, nobody likes to be an outcast, do they?”. Notice which topic Matt chose to bring up to the conversation where the main theme was suicide. He could have mentioned numerous issues such as unemployment or family problems, but he chose to describe something that he had experienced since he was a child: feeling rejected for being an expressive person. ‘Effeminate’ was the label. Matt grew up learning that in order to be a man he was required to fulfil a list of behaviours and modes. For those who couldn’t respond to the requirements, something was wrong, strange, unnatural or abnormal. Fortunately, Matt asked for help and received support.

As a mental health professional, I understand that one of my most important tasks is to work hard to end stigma. One of the many possible ways to accomplish this is by praising human differences; Emphasising that there are innumerable ways to be a human and they can’t all be fit in boxes or separated by social labels. There are expressive people like Matt, and there is nothing wrong with that. We all have different backgrounds, different genders, different bodies, different abilities and disabilities, different beliefs, different moods, different ways of expressing ourselves, different tastes, and different trajectories. All we have is difference! We are rich in diversity, but as society we insist in creating social categories and excluding those who do not fit in. This indicates our difficulty of dealing and living with our differences. Perhaps we could encourage ourselves to make small changes to challenge this; we could push our boundaries, expand our acceptances and understand that social exclusion and stigma kill people. We could develop more empathy. We could save lives.


[1] Baptista, L. A. (1993). A atriz, o padre e a psicanalista: Os amoladores de faca. In L. A. Baptista. A fábrica de interiores. Rio de Janeiro: UFF.

[2] Kinderman, P. (2014). A Prescription for Psychiatry: Why We Need a Whole New Approach to Mental Health and Wellbeing. Palgrave Macmillan.

[3] Homosexuality and Psychology. (n.d.). In Wikipedia. Retrieved July 15, 2015, from https://en.wikipedia.org/wiki/Homosexuality_and_psychology#cite_ref-3

[4] Sculthorp, T. (Producer and Director), Thomas, C. (Editor), & Jack, S. (Reporter). (2015). A Suicide in the Family [Documentary]. United Kingdom: BBC One. From http://www.bbc.co.uk/iplayer/episode/b05rcrx0/panorama-a-suicide-in-the-family

  • Jul 01 / 2015
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What Twitter can tell you about our health: Some insights from the 17th International Symposium for Health Information Management Research 2015 (#ISHIMR2015)

By Siobhán O’Connor (@shivoconnor):

The 17th International Symposium for Health Information Management Research 2015 (http://www.ishimr2015.com/) was a real eye opener for me as I got an insight into the power of Twitter analytics and how it can be applied in public health research. A poster presentation by Professor Peter Bath (@PeterABath) from the University of Sheffield on one of his doctoral students’ work demonstrated the value of this amazingly powerful digital health tool. Wasim Ahmed (@was3210) the PhD student in question is using Twitter to understand the Ebola outbreak in Western Africa by collating all the hashtags on #Ebola.

IHAWKES blog 1

Speaking to Wasim after the presentation I was shocked to hear his dataset was in the region of 26 million!!! No small feat for a PhD student to get to grips with. Not surprisingly his poster described the methodological challenges with gathering and analysing this data and some possible solutions for other researchers to follow in the future. No doubt Twitter will become an important data source for numerous health related topics, in particular global health, as more people get online and share their experiences and ideas on the platform. Researchers are only starting to tap into its potential to monitor health related events as they happen in real-time and the wide ranging impact they have on people across the world.

IHAWKES blog 2

Determined to show me some of the nifty analytics that could be done on Twitter, Wasim encouraged me to tweet through the conference at St John’s University in York and showed me his results at the end. It turns out you can very quickly do a lot of clever things on the back of Twitter data such as network analysis and visualisation through a free open-source (love it!!) piece of software called the NodeXL (@nodexl) which creates network overviews and graphs of data through Microsoft Excel. It’s such a quick and easy process that Wasim had the analysis of all the Twitter chat on #ISHIMR2015 done by that very evening the conference finished, after I’d returned to the University of Manchester two hours later. What a turnaround – if only all research analysis was that quick and easy!! PhD students would be laughing!

IHAWKES blog 3

As it turns out, thanks to Wasim’s subtle prompting I became the “most influential” Twitter chatterer at the conference thanks to retweets and favourites by other people who were attending and following online. As you can see from the more advanced analysis image the main discussion revolved around one of the plenary speakers, Professor Frances Mair (@FrancesMair), from the University of Glasgow, and her talk on “Bridging the Translational Gap: Key Issues in Health Informatics Implementation” as she raised several thought provoking ideas around treatment burden and how digital tools can both add to and reduce this for patients.

Well it’s certain, Twitter is becoming an important digital tool that will not just help patients in the future but also public health agencies and frontline doctors, nurses and other staff on the ground by providing them with rich data from which they can make critical decisions to solve health issues facing our society.

  • Jun 03 / 2015
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Academia, Current Research, David Blane

Public health, health inequalities and neoliberalism

Photo by Darko Stojanovic. © Dec. 10, 2014. © CC0 Public Domain via Pixabay.

Photo by Darko Stojanovic. © Dec. 10, 2014. © CC0 Public Domain via Pixabay.

By David Blane

Neoliberalism is bad for your health.  That was the take-home message from Professor Paul Bissell, the invited speaker for the Institute of Health & Wellbeing’s Maurice Bloch seminar series on April 20th 2015.  Prof Bissell began his talk by summarizing the now familiar arguments of Richard Wilkinson and Kate Pickett, from their book The Spirit Level.  Their main thesis, supported with considerable empirical evidence, is that those advanced capitalist countries with the greatest income inequality do worse across a range of health and social outcomes compared to those that are more equal (a case also made in a recent IHAWKES Election Special guest blog by Professor Andy Gumley). Continue Reading

  • Mar 18 / 2015
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We need to talk about *******: Public engagement for “taboo” topics

By Olivia Kirtley:

As a child, I grew up watching the Royal Institution Christmas Lectures on TV and feeling a tremendous sense of excitement as these famous scientists submerged PhD students in ice water baths, cuddled lemurs and dissected brains, all in the name of public engagement with science.  During my PhD, I’ve been on lots of courses designed to equip scientists with the wherewithal to take their research out of the ivory towers and into people’s everyday lives. However, it has rapidly become clear to me that if your research doesn’t go whizz or bang, you are somewhat out of luck.  For those in health research, this can cover rather a lot of areas, e.g. sexual health, alcohol and substance abuse, and indeed much of mental health research.

One day I lamented this fact in a meeting and one of my supervisors asked “Well, what public engagement would you like to do?”  To which I had to answer, “I don’t actually know.”  So far removed does my research seem from all of the activities that are catered for within the existing public engagement courses I have been on, that I am not even sure what opportunities there would be.  I cannot make a jelly cell to talk about psychological distress and there is no plush cuddly microbe for emotional pain.  For me, this raises a question of whether or not health science, or at least some areas, needs some more specialist assistance in making our research accessible to the public.  Particularly for PhD students in these fields, specialist public engagement training catered to the unique needs of topics which are often felt to be “off-limits”, could be of huge benefit, changing the way they think about their research for their entire careers.

When asking for ideas about how we can better talk about suicide research with the public, I have frequently met with the response “Oooh…well that’s quite a tricky topic”. Or “that’s not really something we could talk about.”  If we can’t even get other researchers to accept our topic as something to be talked about in public, how can we hope to engage non-academics with our research?

Maybe we could frame it differently?  Perhaps we should talk about good mental health as a key part of overall wellbeing (which it is)?  But at some point, I am probably still going to have to say “suicide”.  Shying away from topics that may be perceived as sensitive or emotive helps to perpetuate stigma.  Stigma costs countless lives each year and people suffer with mental and physical health conditions, as well as huge health inequalities, in silence because they are embarrassed, ashamed or too isolated to tell someone or seek help.  I feel strongly that as researchers we have a duty to use our privileged position to break down barriers around openly discussing health issues.

Public engagement is in vogue as increasingly more funding bodies require scientists to communicate their research to the public who fund it.  The bottom line though, is that our public engagement activities have so much more potential than acquiring grants; they can start conversations about important health issues that could result in real positive change for individuals experiencing various mental and physical health conditions, as well as those who support them.

What are your experiences of public engagement in health and wellbeing research?  Do you have any good ideas for/experience of engaging the public with sensitive research topics?

  • Jan 14 / 2015
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Academia, Ruth Agbakoba

Five top tips for writing a conference paper

© Pexels. 2014. Licensed under the Creative Commons Zero (CC0) license.

© Pexels. 2014. Licensed under the Creative Commons Zero (CC0) license.


By Ruth Agbakoba

This is my first ever blog post for IHAWKES and I feel that it is quite a fitting time for me to reflect and share some of my personal experiences as a doctoral student.  I am a final year MRC DTP (Medical Research Council, Doctoral Training Programme) funded PhD Student evaluating the implementation of the Living It Up project (a digital health and wellbeing service) which is part of a £37 million UK wide programme called DALLAS. I am particularly interested in a) how innovative digital technologies and services can be used to enhance health and wellbeing and b) how such interventions can be routinized into people’s daily lives. The project is supported by NHS 24, Scottish Centre for Telehealth and Telecare (SCTT), the Scottish Government and Innovate UK (Department of Health). Continue Reading

  • Dec 03 / 2014
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Treatment burden: a new agenda for research across the globe

By Katie Gallacher:

Health care providers across the globe are facing one of their biggest challenges yet: the increasing volume of people with chronic disease, and the enormous proportion of those with multimorbidity (more than one long term condition). It seems however, that whilst trying to keep up with demands, governing bodies and policy makers have forgotten one important thing…the patient experience. Amidst the perpetually multiplying disease centred guidelines and payment for performance measures, the individuals undergoing the investigations and treatments have gone somewhat unnoticed, as have the huge burdens that are placed upon them by health care providers. I say this from my experiences as a primary care researcher, general practitioner, and daughter (both my parents have required considerable interaction with health services). However, a body of research is emerging from across the world that explores the impact of healthcare demands on patients and their carers. I am proud to be studying for a PhD on this very topic: the treatment burden of chronic disease.

The term treatment burden is used to describe the workload of health care that those with long term conditions are required to perform in order to manage their condition and the impact that this has on functioning and well being. Workload encompasses the tasks carried out by patients during the management of their illness (e.g. taking medications, reading information leaflets, arranging transportation to appointments, making lifestyle changes). Treatment burden can be affected by the nature of the illness and treatments available, presence of comorbidities, and importantly, the organization of health services and the practices of health practitioners. Poor acknowledgment of multimorbidity in clinical guidelines causes a particular problem, as health care practitioners attempt to follow rigid disease centred targets that contradict one another and amalgamate to an unmanageable level of work for everyone involved. Additionally, patients may have differences in their capacity (meaning ability to handle the workload) resulting in different levels of burden despite the same workloads. Capacity may be affected by, for example, literacy, functional morbidity, financial resources or social support.

There has been a growing interest in the exploration of treatment burden for those with long term conditions. In 2009, an editorial in the BMJ called for ‘minimally disruptive medicine’, the practice of realistic health care that is tailored to the individual’s preferences and daily activities. The authors (two of whom are part of my supervisory team) argued that without this, individuals with long term conditions are less likely to adhere to management plans or engage with healthcare providers as they become overburdened by treatments that are difficult to fit into their lives. This year the BMJ commissioned another editorial by the same authors that further discusses the concept of treatment burden, an indication this is an area of research receiving considerable attention in the literature.

A plethora of papers from across the globe have recently been published on the patient experience of treatment burden, and initial methods of measurement have been developed. Papers have arisen from the UK, US, France and Australia (click here and here to see some references).

A theoretical paper was also published this year that examines the interactions between patient capacity and workload. Healthcare utilization is described as an experience characterized by social networks, with individuals and their support networks navigating health services under the controls of health care providers and the social and economic resources available to them.

Although this area of research is new, the theory behind it is not. In 1985 Corbin and Strauss conceptualised three types of work associated with chronic illness: illness trajectory work; everyday life work; and biographical work. Illness trajectory work consists of the course of illness over time and the work that goes into managing this process, such as regimen work and crisis management, closely related to treatment burden as we think of it today.

So what is the aim of all this research? Hopefully a deeper understanding of what it is like to walk in the shoes of those with long term conditions will encourage holistic health care that prioritises improving lives rather than reaching disease centred targets. We’ve still got a lot of shoes to try on, but we seem to be stepping in the right direction.


  • Oct 08 / 2014
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Getting over that scholarship hump. You’re too busy? Please apply, here’s why!

By Siobhán O’Connor:

You may wonder as a busy PhD student why you should spend your precious time applying for postgraduate scholarships. You no doubt have a million and one deadlines, a growing stack of articles to read, and a very rough draft of a paper you swore you’d finish weeks ago. However if you have an interest in public health here are my top 10 reasons why you should apply for a Young Forum Gastein (YFG) scholarship.

  1. The YFG scholarship is much more than a travel bursary to attend the European Health Forum Gastein (http://www.ehfg.org/) conference. It also incorporates a jam-packed programme that enables you to interact with over 70 other Young Gasteiners. These scholars are a diverse mix of researchers, policy advisors, economists, doctors, nurses and many other clinicians from all across Europe, who are working in public health. They are eager to share their knowledge and experiences with you which are invaluable to a fledgling researcher.
  1. As the YFG scholarship is jointly sponsored by the International Forum Gastein, the European Commission and the World Health Organisation (WHO), the speakers and delegates at the EHFG conference are senior academics, researchers and policy analysts as well as Members of the European Parliament (MEPs), senior staff from the European Commission, the WHO, industry, and patient organisations. Making these types of contacts at an early stage in your career can give you many more options in the future and help you realise that there is life after your PhD!
  1. Although I have a particular interest in digital health and lapped up the two sessions on eHealth, there is a broad range of public health topics covered. I gained just as much from attending sessions about public health leadership, personalized medicine, and EU health policy to name a few as they gave me new perspectives from which to view my own research. Whatever your area you will find something that intrigues and inspires you.
  1. This forum is also a great way to promote our own research, as there is an opportunity to present a poster. Although only a few are selected, it is worth submitting an abstract as it’s a great experience. You get to practice your presentation and communication skills, and the feedback can really enhance your research.
  1. Getting involved in a working group in another option where you can participate in writing blogs on conference proceedings, interviewing senior attendees, or contributing articles to the daily newsletter. Each working group also debates upcoming EU law such as the new Cross-Border Healthcare Directive. This is a great way to boost your confidence and help improve your written and oral communication skills.
  1. One element of the Young Gastein experience I really valued was the personalised mentoring session. I was lucky to be paired with Professor José Martín-Moreno, a professor of preventative medicine and public health at the University of Valencia. To say he crammed in as much career advice and guidance as possible in an hour is an understatement and it will definitely help to shape my future career choices.
  1. We also received a series of specialised careers talks; one from the WHO, the second from the European Commission, and the third from two public health consultancy firms. They all shared insights into their current roles, discuss how they progressed throughout their careers and outlined the skills that were needed in their professions. A frank Q&A session helped to us to gain an understanding of the pros and cons associated with these careers.
  1. For those of us with burning questions on how the new European parliament is going to tackle public health challenges, we got our questions answered at a one-to-one interview with the newly appointed EU Commissioner-designate for Health and Food Safety, Dr Vytenis Andriukaitis. We were able to pose any question or make a recommendation on what Europe should focus on until 2020. If you have a point to get across then this is the forum to do it.
  1. If you’ve very adventurous then you could also get the opportunity to practice your literary skills, by writing a poem which is broadcast live at the end of the conference, or participate in a video documentary which is available online. And don’t forget to tweet, tweet, tweet – a Young Gasteiner life skill that you will perfect throughout the week!
  1. And of course last but not least being a YFG scholar also means you get to visit beautiful Austria, where you can join early morning hikes into the Alpine mountains, practice yoga at sunrise, relax in the indoor saunas (warning ** these have nudist areas**), spend a day pottering around Salzberg, or try out local brews, gulasch, schnitzel, apfelstrudel and other delicacies. The list is literally endless!

If you are interested in applying check out the website at: http://www.ehfg.org/young-gastein.html or Twitter feed @YoungGasteiners.

Young Forum Gastein Scholars 2014

Young Forum Gastein Scholars 2014

  • Oct 03 / 2014
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Starting your PhD: A view from the summit!

So, you’ve made the decision – and it’s a big one – to do a PhD. One or two people will now play a big role in your life for the next few years – your supervisor(s). And – if you feel a bit daunted and unsure of how that relationship will develop, your supervisor probably feels the same way!

You can Google “What is a good PhD supervisor?” and you’ll find a lot of articles. Or – my own favourite – you can go to Jorge Cham’s PhD cartoon strip. But, the supervisor there is male and bearded and I am neither – honest. So, drawing on my own (fairly long ago!!) experience of being a PhD student and of supervising a fair number of (I’m pleased to say) successful PhD students, here are my 10 tips.

1. Don’t be shy.

Initially you and your supervisor need to lay out some ground rules about meeting – frequency; content; expectations. I tend to see my student once a week, at least during the first year – that gives us all flexibility. But, as you move into the second year we may meet less frequently – you will have a plan and be getting on with it. Weekly meetings might be a disruption. You need to decide what suits you – and tell me. But, if you need to ask me something, I should be contactable – if not in person, at least by email. So, don’t be shy about contacting your supervisor and agreeing a way of working that you are both happy with.

2. You’re not the only one in my life!

This brings me to the next really important truth – your PhD will probably become all-important in your life (especially if you are full-time). However – you are one of many activities for your supervisor. This doesn’t mean that you aren’t important or they don’t care, but you will be one of many competing priorities. So – you might not get an immediate response to your email. If you need a quick reply, chase me. But try to judge when to chase and when to wait. HOWEVER ….

3. It’s OK to make me wait.

One of the problems for an academic is that our sense of work-life balance is terrible!! So, we might decide to reply to your email – or send a request – at midnight, or on a Sunday, or any other really stupid time! The sensible supervisor DOES NOT expect a reply then. If they do, they’re wrong (unless you have pre-arranged it for a very good reason). So, it’s OK to make me wait.

4. Teach me new things.

Supervisors – believe it or not – don’t know everything. So, if you find a really interesting paper, a new theoretical approach or a research approach that might be useful – tell me about it. Chances are it’s passed me by. Likewise, I will try to do the same for you.

5. It’s your PhD.

I might have had the original idea – or you might have come to me with the PhD idea. Either way, it’s your PhD. My job should be to steer you away from the inappropriate, the wacky or the plain non-starter. It shouldn’t be to stop you doing something, just because I haven’t thought of it – but you will need to convince me.

6. It’s a training process.

Sure, getting academic papers is great (for you and me) – but you also want to get the training that can take you on into the work of academic research (if you want) or into other areas. So we should always be thinking and talking about that too.

7. Please, please, please write …..

I will try to get you writing from early on in your PhD – sections for chapters, protocols, a thesis skeleton. Lots of people HATE doing that. Couple that to the fact that PhD students are pretty high achievers and self-critical and ….. you can’t hand in a piece of writing that isn’t “finished”. Guess what – supervisors are just the same when they write their own papers. So, we understand that feeling. But, the point is – if you do find writing a challenge, much better to come to it early. Then you and I can work on it together. (Though, going back to point two – remember to give me time. A deadline helps here!)

8. I’m your first port of call (I hope).

A PhD can be a long and hard road. There is plenty written about the toll that doing a PhD can exact on people – both physical and mental. So, if you are finding it over-whelming ….. please come and talk to me. The more experienced a supervisor is, the greater the chance they have heard this before and know how to help you, or point you in the direction of help.

9. If I’m not your first port of call (or if I’m the problem)….

Talk to others – fellow students, student advisory service, advisors/reviewers or (at Glasgow) your Postgraduate Convenor. But mainly, talk to someone….

For me, supervising PhD students is akin to having kids! You start new to the whole, extended research process of a PhD and need a lot of support. But slowly, steadily, you develop and find your feet and confidence. And in time – it’s the best feeling in the academic world to stand as a supervisor and see your students graduate and take off into the wider world.

Oh, and before I forget:

10. Bake

I seem to have a bunch of very talented bakers …… just saying!!

Good luck.

Kate O’Donnell is Professor of Primary Care Research and Development, in the Department of General Practice and Primary Care, University of Glasgow. She is also the outgoing postgraduate convener for the Institute of Health and Wellbeing and supervisor to more than one of the IHAWKES bloggers. You can follow her on twitter @odo_kate.