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  • Sep 10 / 2015
  • 1
Current Affairs

Suicide Prevention: From Illness and Risk Factors, to Thoughts and Actions

Photo by Austin Ban ©. Unsplash. Used with permission.

 

By Tiago Zortea

As a PhD student carrying out research in suicidality, I am recurrently asked why people take their own lives. The thing is, there is not an obvious, quick, or complete answer. Suicide is a complex phenomenon, and it involves biological, psychological and social factors that interact with each other, and these interactions vary across cultures, genders, and ages. The main reason why researchers have been working so hard to understand it and to develop effective interventions is the fact that there is no time to lose when the aim is saving lives; equivalently, someone dies by suicide every 40 seconds somewhere in the world [1]. Continue Reading

  • Sep 02 / 2015
  • 0
Profcast

The Profcast: Professor Carl May

In our latest Profcast IHAWKES speaks to Professor Carl May, Professor of Healthcare Innovation at Southampton University.

Why did you become an academic?

There are many different ways of plotting this story but the simplest, and perhaps the one that is nearest the truth, is that I found that I just loved the work. I did as a student and I do now as a professor. These are fantastic jobs to have. I can’t think of another career where I would have had the opportunities that I’ve had as a university researcher and teacher. My collaborators are often my friends and some of them are very good and close friends indeed.  Together we do great work. This may seem a bit rose-tinted, but it’s true for me. Continue Reading

  • Aug 26 / 2015
  • 0
PhD Experience

Big data – how to predict our future health and wellbeing

By Siobhán O’Connor:

As a fledgling researcher, I heard the term ‘Big Data’ several years ago when it appeared on the cover of New Scientist. It was billed as an exciting new field that was evolving at the peripheries of lots of disciplines and one that could potentially revolutionise them all. Having scanned the article briefly I didn’t make much of it at the time and resigned it to the realm of techies, one which would have little impact on me and the way I lived my life. However, as the years ago by and the proliferation of digital data seeps into every facet of life; from monitoring what I eat and the exercise I do via mobile apps, to sharing my personal data on family, friends and life events on social media, I realise I may have missed the central point of the article. The technology to continuously monitor human life (both biological and behavioural) and the environment that surrounds us is here.

When the opportunity arose to learn more about Big Data, I jumped at the chance, as I could see its potential for post-doctoral research. The Association of Commonwealth Universities (ACU) was holding a summer school on the topic of ‘Big Data and the Digital Divide’ for postgraduate researchers and I was lucky enough to secure a scholarship to attend. The weeklong initiative was held in Canada and brought together over 20 international researchers from several commonwealth countries.

On our first morning we got a tour around Toronto from our student ambassadors, before travelling to the University of Waterloo where we listened to interesting perspectives on Big Data from two industry speakers. Kevin Keane, co-founder of Brainsights, spoke about a range of wearable technologies like FitBits and Hexoskin that can measure a variety of physiological signs which are enabling us to quantify and understand different aspects of human behaviour. The following day, Mark Damm the CEO of Fuse Forward outlined how cloud-based analytics platforms can be used to process large, diverse datasets that can help us better predict a range of outcomes and impacts. That afternoon, Professor John Hirdes from the School of Public Health discussed how Big Data could impact the healthcare system if we used standardized clinical assessments to collect digital data and create more robust predictive clinical decision support systems for doctors, nurses and other health professionals.

On Tuesday morning, Dr Christian Boudreau spoke to us about how statistical techniques such as survival analysis are being used to query large amounts of bone marrow data. This is helping researchers to understand how long patients will survive if given a particular treatment or drug. A trip to nearby Wilfrid Laurier University to meet Dr Colin Robertson and his team resulted in us appreciating how geographical information systems can contribute to Big Data and help us understand the spread of diseases such as Japanese Encephalitis in Nepal. We were then treated to a real Canadian experience by going camping and canoeing at the nearby Laurel Creek nature reserve. Of course important data can also be gleamed from the natural environment, which heavily impacts our health. We were given a demonstration of a miniature drone or UAV (unmanned aerial vehicle) that remotely collects environmental data such as wind speed and direction, air temperature, agricultural practices and other geospatial data. After a campfire, sing-along and too many roasted marshmallows, we spent Wednesday morning canoeing around the reservoir with Dr Robert McLeman to learn how citizen science initiatives can help us monitor environmental changes in the weather as well as animal and plant species through mobile technology (http://www.ontarionature.org/protect/species/app.php).

For the last leg of our journey, we travelled to Western University in London, Ontario where Dr Mark Daley and Dr Dan Lizotte spoke about the difficulties of statistically interpreting big datasets. They highlighted the importance of robust algorithms for drawing correlations and causation, as mistakes can lead to glaringly strange results as shown by Google’s initial Flu Trends data which has since been corrected. They were joined by Dennis Buttera from IBM, who reiterated this point from the industry perspective. He outlined the challenges IBM face supporting different businesses from multiple industries with analytics capabilities. This in part is due to a lack of computer and data scientists and he highlighted the urgent need for many more skilled graduates in these areas. He recommended a book called ‘Thinking About Data’ to educate everyone from children to adults on Big Data, which is now at the top of my reading list (sorry pile of JAMIA papers sitting on my desk!). In relation to healthcare, he noted that precision medicine is taking off as people are using large DNA and genomic datasets to personalize drugs and treatments for individual patients and the potential benefits of this for society are still in its infancy.

As the week drew to a close and we said our goodbyes after a trip to Niagara Falls. As it turns I couldn’t have been more wrong about Big Data – it is here and it is going to affect us all as the wealth of digital information at our fingertips will only continue to grow and grow. For health researchers that means more multidisciplinary collaboration with industry and other research disciplines, both from the technical and social sciences, to broaden and enhance our understanding of how Big Data can improve health and wellbeing.

Siob_T_2siob_Toronto

  • 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 29 / 2015
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PhD Experience

Lions and tigers and theses! Oh my!

By Olivia Kirtley:

Blog posts and advice columns about writing your thesis abound and the vast majority speak about it with great reverence; it isn’t just a thesis, it’s “The Thesis”, “The Big Book”, the Goliath to your David, the magnum opus of the last 3 or 4 years of your life. The thesis as a portrait of academic Herculean struggle can strike fear into the hearts of many PhD students. It feels like an unknown, a dark forest with lions and tigers and bears, but perhaps writing your thesis isn’t as scary as it first sounds?

Oil can!

Just like the Tin Man, if your writing is going to go smoothly, your writing skills will need regular oiling, which means…more writing! From the very start of your PhD, if you do a systematic review, try and write it up for publication. If you have data, write it up for publication. If someone “scoops” you and publishes that dream study that you have carefully planned in your head for months or years, why not blog about it or write a commentary on it? Reports, book reviews, blog posts, articles for the university magazine; all of these things will keep your writing skills from becoming squeaky. I was very lucky that I had the chance to do quite a bit of writing before starting on my thesis and I definitely feel this made it a lot less terrifying. Having received feedback on my writing from my supervisors and peer-reviewers meant I was aware of areas where I could strengthen my arguments or stylistic holes I may fall into. Obviously, you can write things without showing anyone, but opportunities to get feedback on your work are truly invaluable. Take some lion courage and let other people look at your work. Your future self will thank you.

If only I had a brain! But don’t forget to have a heart.

There is something about the prospect of writing a thesis that can make one feel completely overwhelmed. Maybe it is the idea of writing so much, the amount of time it will take, having to weave together all of your work into one story, or indeed, all of the above. How will you accomplish this? If only you had a brain. But you do! You designed your studies (or at least had some input into them, if it was a pre-organised grant), you have worked with your data, you have read all the papers. You are the expert! Own your research (warts and all) and tell its story.

But also don’t forget to have a heart. Why did you do this research? What does it mean to you? What could it mean for other people? By the time you get to the stage of writing your thesis, it is easy to feel tired and jaded, but take some time to remind yourself why you love your research. Not only will this enthusiasm shine through in your thesis, making it much easier to write and also for others to read, it is this love for what you do that will see you through the long nights and working weekends of your final year. Thinking about the hundreds of people who have shared some of their most private and painful experiences of suicide and self-harm with me, is the strongest possible motivation; my thesis is made up of their stories and I have to tell them with my data. Maybe the contents of your petri dish will cure cancer? Maybe your research could change policy and help millions? Always have a heart and always put that in your research.

A hippopotamus? I’d thrash him from top to bottomus!

When your thesis is finished and in its nice shiny binding, it is a big book. But, before that point, it is a much smaller beast. Your thesis is made up of chapters, and these are made up of sections, containing sub-sections and sub-sub-sections; small chunks of writing that when all fitted together, will form the complete picture of your work. When I first began to write my thesis, I would set up a blank word file for each chapter and write in the major headings, e.g. abstract, introduction, methods, results, discussion and conclusions. Then I would go back through again and add in sub-headings for each of these sections. In the introduction of a chapter, for example, I may have sub-headings for self-harm, self-harm and physical pain, self-harm and emotional pain, the relationship between emotional and physical pain, etc. These sub-headings could change and I often found myself adding more in as I wrote. Sometimes I would sit down to write one sub-section and then realise that actually I got through it more quickly than I thought I would, so I went ahead and started on another sub-section. Your thesis ends up as a hippopotamus, but that’s not what you sit down to write. A little bit at a time, persistently plugging away writing small sub-section after small sub-section will eventually turn into a finished thesis.

Writing your thesis will be hard, but it doesn’t have to be terrifying. As long as you keep putting one red slipper in front of the other, you’ll be in Emerald City before you know it.

  • Jul 16 / 2015
  • 1
Academia

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.

References:

[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
  • 0
Academia

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 17 / 2015
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Current Research

Enabling patient-centred care through information and technology

By Siobhan O’Connor:

A snapshot of this year’s Kings Fund Digital Health and Care Congress in London highlighted the focus on enabling patient-centred care through information and technology. Beverley Bryant, Director of Digital Technology for NHS England outlined the NHS’s Five Year Forward View and the Department of Health’s Personalised Health and Care 2020 framework. These two important strategy documents outline how health services in the United Kingdom will be transformed through information technology over the next fives years.

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Mike Clark ‏@clarkmike  4h4 hours ago

#kfdigital15 @Beverley_Bryant Director of Digital Technology – plans to enable patient-centred care – underpinning @nhsengland strategies

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At the heart of these are a number of key commitments including:

  • Patients will have access to and write into their health records,
  • Citizens will have a single point of access to all their health transactions,
  • NHS111 urgent care services will be digitised and linked to nhs.uk,
  • uk will be customizable to reflect specific local needs,
  • Personalized, mobile care record for parents of newborns will be tested,
  • The impact of digital developments on inclusion and equity across the care spectrum will be considered,
  • Individual digital care accounts will be piloted.

These promise to address some current issues between health and social care such as a poor ‘customer’ experience, digital exclusion, security concerns in relation to accessing health data, the modernization of the underlying technical infrastructure and working across professional silos among others.

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Amit Bali ‏@amitkbali  4h4 hours ago

@Beverley_Bryant describes need to modernise way we offer services – the public want it. Usability vs security balance is key. #kfdigital15

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Ali Rogan ‏@AliRogan  4h4 hours ago

#kfdigital15 important to learn from banking industry for citizen confidence in data security. @beverley_bryant

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siobhan kings

In particular, Beverly highlighted the progress made in primary care with greater flexibility in booking GP appointments online, better access to electronic prescriptions, more ways to communicate with family doctors over web-based media and now plans are underway to enable patients to register with a GP practice online to further reduce bureaucracy and remove barriers to access for citizens.

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The King’s Fund ‏@TheKingsFund  4h4 hours ago

.@Beverley_Bryant: we’re aiming to enable people to register for GP online – more convenient and save admin burden #kfdigital15

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The crux of her discussion was taken up by Dr Paul Rice, Head of Technology Strategy for NHS England, who went on to outline a roadmap for local delivery of these strategies in the form of a digital maturity programme. This requires NHS trusts to have a number of key organisational capabilities including decision support, asset and resource optimisation, remote and assistive care and citizen activation. Some practical examples were given of current roadmaps in Bristol and Cumbria to demonstrate how trusts can move towards a paper-free environment by 2020.

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Siobhan O’Connor ‏@shivoconnor  4h4 hours ago

@paulricenhs talks digital maturity in the #NHS pockets of excellence will spread “paper free” by 2020 #kfdigital15 @TheKingsFund

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So what does all this mean for researchers in the health and wellbeing fields? Well as always, robust evidence is required to underpin these new approaches, validate them as worthwhile investments and explore their impact on the health and social care landscape in the UK.  So if you have an interest in all things eHealth then check out the presentations from all the speakers at this year’s King’s Fund conference here.

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The King’s Fund ‏@TheKingsFund  4h4 hours ago

Patients in control of own info is ‘on roadmap’ says @PaulRiceNHS. Doc/patient views on online records: http://www.kingsfund.org.uk/reports/thefutureisnow/#patient-and-doctor-views #kfdigital15

  • Jun 03 / 2015
  • 1
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

  • May 27 / 2015
  • 5
Anna Isaacs, Current Research, Methods

Is there a ‘cognitive dissonance’ in public health research and if so how can we address it?

Photo by Leroy Skalstad. © 2015. © CC0 Public Domain via Pixabay.

Photo by Leroy Skalstad. © 2015. © CC0 Public Domain via Pixabay.

By Anna Isaacs

It has been seven years since the WHO Commission on the Social Determinants of Health launched its report demonstrating categorically the profound impact of social and economic inequalities on health outcomes and declaring that “social injustice is killing people on a grand scale”.  The powerful effects of socioeconomic, structural and political influences over individual behaviours on our health are well known and well discussed. Yet, so often in public health research, we seem to park this knowledge at the door and continue working on behavioural health interventions that bring minimal, short-term benefits, if any at all. We may nod to the importance of culture, or socio-economic status, or even incorporate a socio-ecological perspective, but it is incredibly rare for such research to challenge, or even examine, the more fundamental factors that result in ill health. Continue Reading