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  • Feb 11 / 2015
  • 1
Methods

So you want to go systematic? Three points to prevent you weeping into your keyboard

By Olivia Kirtley:

Conducting a systematic review has become somewhat of a rite of passage for PhD students.  Systematic reviews can sometimes get a bad press for being “boring” or “unwieldy”, but have the potential to provide critical insight into the state of an area of knowledge as we know it (or think we know it).  Often in the cold light of a systematic review, things that we thought were fact are revealed to be spurious.  Doing a systematic review is no mean feat however, from either a logistical or an academic perspective. Based on my own experiences of conducting a narrative systematic review, here are a few pointers to consider:

  • How many hits did I take again?

One of the most important things when conducting a systematic review is to be organised and keep copious detailed notes of every tiny little thing you have done.  And I really do mean everythingThis is a great excuse to go and buy yourself a nice new notebook or set up a shiny new Excel sheet to log everything you do.

Things you will want to keep notes on:

  • Your search terms (e.g. self-harm, suicid*)
  • The dates you conducted your database searches
  • Which databases you used, e.g. PsycINFO, Medline, PubMed
  • How many hits you got from each
  • The exact format in which you entered your search terms into each database (we’ll come back to this in a minute)

In addition to these notes, you should fill out (and include in your review) a PRISMA flow diagram.  PRISMA provides best-practice guidelines for conducting your review or meta-analysis, from producing an accurate, replicable search methodology, to what kind of things your review should cover.

Create an account within the databases you use, so that you can save your searches.  This will save you countless hours of trying to remember the exact format that you used to enter your search terms if your search times out or you end up having to update your review at some point.  Trust me on this! 🙂

You will also want to use some form of reference management software (e.g Endnote), so that you can transfer all of your search hits (not just the ones you think are relevant, that comes later!) to a place where they will not change, disappear or time-out if you get a phone call or start reading PhD Comics.

  • This is not a magnum opus.

You’ve read every single one of these X studies a hundred times and you know them inside out.  If someone asked you how many participants ate breakfast on the morning of the study in Bloggs et al (2014), you could tell them and also say how many sugars they each had in their coffee.  You want to show everyone that you know all of this information. Don’t.  This is a systematic review, not a magnum opus.  It is not supposed to be an all-you-can-eat buffet of details about each study, it is a finely curated set menu which only includes certain, relevant details that are specific to your research questions.

Leading onto the last point, which is…

  • This message could not be delivered…

Systematic reviews are usually longer than other types of papers, but this does not issue you with an automatic licence to bore the socks off people or for lazy (or even zero) editing.  Just as you would do with an empirical article, always ensure you trim the fat; keep the paper as lean as possible and make sure that your take home messages come through loud and clear.  Your systematic review should not be a 50 page list or read like a bibliography.  Even though you are looking at previous work, the insights and conclusions you arrive at should be new, interesting and move the area forward.  This type of paper is about synthesis, not repetition.

As that great orator, Dr Kelso, once said “nothing in this world worth having comes easy”.  Doing a systematic review can be tough, but you will get there!  It is a great learning process and a fantastic opportunity to develop detailed expertise in your area.  Who knows?  Maybe your new insights could provide the platform for a quantum leap in your field!

Do you have any top tips for conducting systematic reviews? We’d love to hear them in the comments or on our Twitter feed @IHAWKES1.

  • Feb 04 / 2015
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Matt Jamieson, PhD Experience

After your PhD – what’s the next step

Photo by Rama Krishna. © 2016. © CC0 Public Domain via Pixabay.

Photo by Rama Krishna. © 2016. © CC0 Public Domain via Pixabay.

By Matthew Jamieson

In the months before began my PhD I worked in a shopping centre in the suiting department. During this time I would tell my colleagues I would soon be a doctor (though not a proper one) and, being mostly undergraduates, they seemed suitably impressed that I was embarking on what was presumably quite a professional career. This reaction made me feel like I knew where I was going. I was an executive academic, with shiny shoes and wearing a slim fit shirt and tie. Continue Reading

  • Jan 28 / 2015
  • 6
Methods

A good thesis is a finished thesis!

By Arlene McGarty:

I bring you my first IHAWKES blog from the “preparing to write up” phase of my PhD. And boy, what a nice phase it is. It’s that point in a PhD when all the research has been conducted, the stresses of recruitment and data collection are a distant memory, that never-ending analysis did in fact end, yet the dreaded “writing up” phase has not fully begun. It’s a very welcomed, albeit short, period of calm in an otherwise hectic process. So, in a bid to prolong the serenity a little longer, I’ve put together 5 top tips which I’ve found particularly helpful as I prepare to write up.

1. The writing should have started a long time ago

You’ve probably heard this from day one of your PhD, from everyone that has ever done a PhD. And I’m sorry to jump on the bandwagon, but they’re right – writing as you go makes a huge difference. It’s not a case of starting chapter one on day one, but simple things, such as taking notes whilst reading or drafting method sections when data collection procedures are still fresh in your mind, will prove extremely useful as you prepare to write up.

2. Plan ahead

It’s important to develop a general plan for your thesis and think about how it will be structured, what your chapters will be, and to familiarise yourself with your Institute/College thesis guidelines. This initial plan will give a structure to what you’re writing and soon you will start to see how different elements of your thesis fit together. As you prepare to write up, a plan of each chapter – detailing the information to be included within each section and subsection – will keep your writing focused and will let you view your thesis as many small, achievable sections of writing, rather than a single, daunting piece of work.

3. Set deadlines

Deadlines are an important aspect of keeping the writing process on track…and I love them! If it were not for deadlines, I’d still be aimlessly trawling through BMJ Christmas issues and watching Still Game best bits on YouTube. When it comes to writing up, working towards a thesis submission deadline that is months away is unrealistic and more than a little demotivating. Set short-term deadlines with yourself for sections of a chapter and plan deadlines with your supervisor/s for sending them completed chapters. If you struggle with keeping deadlines you set for yourself, get a friend involved who can encourage you to stick to it.

4. Make use of other people and resources

Even though writing a thesis is a very individual piece of work, there are still plenty of people and resources to support and guide you through it. Within the University, there are numerous classes to help you develop the skills required for writing up. There are also books and endless online resources covering writing strategies and techniques; however, top tip 4.1, make sure that reading about writing doesn’t distract you too much from actually writing! Then there are the people around you – fellow PhD students, staff, and supervisors will have a wealth of do’s and don’ts when it comes to writing. Remember, however, that everyone is different, so find a writing routine that works for you.

5. Look after yourself

As the end becomes nearer, there’s a feeling that the more you work the sooner you’ll be finished, which makes non-stop writing seem oddly tempting. However, the most important part of writing up is you, so if you’re not in good health your thesis will suffer. It’s important to get away from writing now and again, so don’t forget to keep active, socialise, and relax.

Finally, as I reflect on my top tips, I find myself questioning the validity of my opening comment – am I really in the “preparing to write up” phase? Maybe this is not a standalone phase but a continual and gradual process over the course of a PhD, as the skills and information required to write a thesis are accumulated and honed over time. As thesis writing goes, those little things you do throughout your PhD – going to classes, writing here and there – are the things your future self will greatly appreciate. And when you put all these little things together, the prospect of writing a thesis will not feel like the overwhelming task that it once did.

  • 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.

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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

  • Jan 07 / 2015
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Profcast

The Profcast: Dr. Gozde Ozakinci

A new year, a new profcast! Today we’re talking to Dr. Gozde Ozakinci, Lecturer in Health Psychology at the University of St Andrews.

Why did you become an academic?

For me, it was a natural attraction. I liked being around people who were excited by ideas about how humans/animals ‘worked’. I also had the fortune of attending a beautiful university in Istanbul (http://www.boun.edu.tr/en_US). I just fell in love with the idea of teaching and doing research with enthusiastic and smart students  in a beautiful environment. And initially (like many psychology students I guess), I thought I’d also combine it with clinical psychology practice. I had done some volunteer research assistance in some labs in my university in health psychology. And I really liked it. But I was not ready to give up my ‘I want to be a therapist’ goal yet. But doubts were creeping in. So, after I finished my degree, I took a year out and went to Cardiff and spent a year in a psychiatric hospital as a community service volunteer. There were 6 of us there and we lived in the hospital too! Oh the stories I can tell but I’m digressing… And there I realised my passion for psychology was in the health domain and not in the clinical world.. I did an MSc  in health psychology at UCL and had the fortune of being supervised by Profs John Weinman and Charles Abraham. And the rest is history! Continue Reading

  • Dec 03 / 2014
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Academia

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.

 

  • Nov 20 / 2014
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Current Affairs

On comet landings and academic inspiration…

By Adele Warrilow:

It would be difficult to write a science blog this week without mention of the Rosetta mission landing the Philae craft on a comet, the result of a ten year project. This inspirational news story has captured the imagination of people around the world – scientists from all disciplines, the general public and children (aka potential scientists of the future). I enjoyed seeing the excitement from the control centre on the news – a particularly great reaction from Professor Monica Grady of the Open University is shown on the BBC website.  In an interview Guardian newspaper, Dr Brian Cox said that showing scientists as people like anyone else can help to inspire the next generation of scientists “If you can make that link – they were people like you! They did their work, they went to university and now they are landing on a comet!… You can do it if you want”.

Even in a high profile space mission things can go wrong, and not just with the technical aspects. There has been considerable media debate about the shirt worn by one of the Rosetta scientists, culminating in a tearful apology. Presenting scientists as real people and not just middle aged men in lab coats is important. My own opinion, however, was that this particular shirt was indeed inappropriate attire for a professional and I wonder why his wider team (e.g., press officers) did not intervene to prevent this – after all they have had ten years to prepare!

As PhD researcher there will be times when our work is going well (even if we are the only ones jumping up and down about finally getting rid of an error code in our analysis) but also times that projects do not go as planned. It is the enthusiasm and curiosity for our subject that keeps us focussed and determined. And you never know, the next big scientific advance may just be around the corner! The “shirt incident” is a good reminder of the importance of the wider training we can access at PhD level such as the Voice of Young Science Media Workshop, practical media training and public engagement.

Last weekend I attended the British Medical Association conference for junior clinical academic. This was a great opportunity to meet others at a similar career stage using a variety of research approaches – from the role of stem cells in skin grafting to global health policy research. Professor Trisha Greenhalgh gave an inspirational keynote speech describing her career and route into academia (as well as competing as a member of the British Triathlon Team!). Prof. Greenhalgh spoke about seeing first-hand the difference that policy could make to health, working on a neurosurgical ward at the time of the introduction of seatbelt legislation. It is this potential to improve outcomes at a population level that has inspired me to have a public health focus to my research.

We hope the Profcast section of our blog inspires you – check it out!

  • Nov 12 / 2014
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Profcast

The Profcast: Dr. Jason Gill

In this week’s Profcast, Dr. Jason Gill, Professor of Cardiometabolic Health at the Institute of Cardiovascular and Medical Sciences at the University of Glasgow answers our questions…

Why did you become an academic?

I was fascinated by science at school and loved the concept of doing an experiment to find the answer to a question.  It seemed much more interesting than just learning something from a book.  So, from a pretty early age I had a vague idea that I would like a career in ‘research’ but I was not really sure what that meant in practice.  But I guess I am a somewhat ‘accidental academic’.  I was reasonably good at triathlon when I was young (competed at the World Championships as a Junior) and went to Loughborough University to study Physics and Sports Science, largely because of its sporting reputation. I trained two or three times per day throughout most of my time at university and would, on occasion, be leaving to go training as some of my fellow students would be coming home from the night before.  Being at university was a convenient way to essentially be a full-time athlete with a bit of studying on the side. But in my final year of my undergraduate degree, I realised that I was not really talented enough to compete at the highest level, so ‘retired’ from competitive sport and found that I suddenly had loads of time on my hands.  I turned the time and effort that I had been putting to training to focusing on my studies and ended up getting a First in my degree.  Because I of this, I was lucky enough to receive a scholarship to do an MSc (this was in the days that these still existed).  I had nothing better to do, so thought why not spend another year as a student.  During my MSc project, on the effects of exercise on lipoprotein metabolism, I realised that this was really what I wanted to do with my life, so my project supervisor, Prof Adrianne Hardman, and I submitted a PhD studentship application to the BHF to continue this work.  The application was successful, and three years later I had my PhD.  I then came to Glasgow for my first post-doc job in 2000 and the rest was history….  Continue Reading

  • Nov 05 / 2014
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Current Affairs

Ebola is a global affair

By Uduak Ntuk:

The 2014 Ebola epidemic has compelled the world to see the fragility of the overall global health system. It is the worst Ebola epidemic to date with nearly 5,000 deaths reported in west Africa’s Liberia Sierra Leone and Guinea, and the death toll keeps rising1,2. Sporadic cases in Mali and the USA have also been recorded. The recent case fatalities in the United States and Spain sadly bring home the truth that viruses do not respect national territories and that ‘when danger lurks somewhere then there is danger everywhere’. It is thus imperative that in dealing with issues like this, prompt proactive global measures are taken.

Ebola Virus Disease (EVD) is characterised by a constellation of signs and symptoms beginning with fever and progressing to diarrhea, vomiting and in a subgroup of patients, hemorrhage3. Human transmission of Ebola is through direct contact with blood, secretions, organs or other bodily fluids of infected people and with surfaces and materials such as beddings, clothing contaminated with these fluids2.  In addition to its health impact on society, it has an overwhelming impact on the economies of the affected countries4.

Several research studies are underway to understand the clinical illness and epidemiological impact of Ebola. A study in the New England Journal of Medicine (NEJM)5 showed that in addition to clinical characteristics and demographic factors, age is an important determinant of disease mortality. Patients under 21 years have a lower case fatality rate than those over the age of 45 years. According to the WHO, trials of Ebola vaccines are to start in December this year following discussions at a high-level meeting on accelerating testing and production, with plans to dispense vaccines in 20156. This decision comes amid a growing realisation that vaccines could play an important part in halting the current epidemic in West Africa.

There is hope that the fight against Ebola can be won. First Senegal and then Nigeria have been declared Ebola-free by the World Health Organisation1. As a Nigerian I feel proud to hear such compliments. Apart from the global respect Nigeria has won for herself in fighting Ebola, it also shows the brave leadership, commitment to ingenuity, courage and sacrifice in the line of duty of the Nigerian people. Such success helps to overcome criticisms of corruption and incompetence that West African governments are often labelled with. But the fight against Ebola in Nigeria wasn’t won with conferences or public relations talks; it took massive efforts to quarantine those infected, and monitor all of their contacts, until the spread of the virus was contained. What then are the other West African countries not doing right to combat Ebola? Guinea, Sierra Leone and Liberia have very weak health systems, lacking human and infrastructural resources and call for support has been given high priority.

The bulk of the human and financial resources being deployed across the epicentre of this outbreak come from Western nations and very few resources have been deployed from sister African countries, which is very disheartening.

The recent issue of whether to quarantine health care workers, returning to their home countries has also been a topic of huge debate. From a public health perspective, the idea of placing primary contacts under relaxed medical surveillance that depends on self-reporting and individual cooperation may comply with respect for individual rights but it appears to be difficult to manage. Perhaps it may be necessary to still adhere strictly to full quarantine even in instances where the primary contacts of index cases are minimal and manageable, and Individuals may be encouraged with different forms of incentives and remuneration for them for the period of their confinement. This may turn out to be be far cheaper and easier than frantically searching for contacts, such as passengers on flights, when a primary contact breaks self surveillance.

How do you think we can handle quarantine in a different way?  Do you think treatment given to health care workers with primary contact with cases is an infringement of their human rights?  I would love to hear your opinion!

References:

  1. World Health Organisation. Ebola response roadmap situation report. Available from http://apps.who.int/iris/bitstream/10665/137424/1/roadmapsitrep_31Oct2014_eng.pdf?ua=1 .Accessed 4 November 2014
  2. Breman JG, Johnson KM. Ebola Then and Now. N Engl J Med 2014; 371:1663-1666.DOI: 10.1056/NEJMp1410540
  3. World Health Organisation. Ebola virus disearse. Available from http://www.who.int/mediacentre/factsheets/fs103/en/. Accessed 29 October, 2014
  4. BBC . Ebola crisis: The economic impact. Available from: http://www.bbc.co.uk/news/business-28865434. Accessed 27 October, 2014
  5. Schieffelin JS, Jeffery GS, Goba A, Gbakie M, Gire SK, Colubri A , et al . Clinical illness and outcome in patients with Ebola in Sierra Leone. N Engl J Med; October 29, 2014. DOI: 10.1056/NEJMoa1411680
  6. World Health Organisation. WHO convenes industry leaders and key partners to discuss trials and production of Ebola vaccine. Available at: http://www.who.int/mediacentre/news/releases/2014/ebola-vaccines-production/en/. Accessed 29 October, 2014.
  • Oct 29 / 2014
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Profcast

The Profcast: Professor Ronan O’Carroll

The IHAWKES are excited to post the first blog in our brand new series, the Profcast! Today, Ronan O’Carroll, Professor of Psychology at Stirling University answers our questions on life as an academic. We hope you enjoy it.

Why did you become an academic?

I initially wanted to be a Clinical Psychologist and it was hard to get on a training course, so I studied for a PhD, purely as a means of increasing my chances of getting a Clinical training place. I applied for a PhD studentship in the MRC Brain Metabolism Unit in Edinburgh, entitled “The behavioural effects of androgens in men”. We conducted a number of placebo‐ controlled studies investigating the effects of testosterone on mood, sexuality and aggression in men. I was fortunate enough to be awarded the Kinsey Institute international PhD dissertation prize in 1984. This came with a $1,000 prize, which I recall was particularly welcome at the time, as my wife and I desperately needed to buy a bath to replace a shower as we had just had our first baby. I really enjoyed my PhD studies. After I qualified as a Clinical Psychologist, I worked for a couple of the years in the NHS adult mental health services, but I realised that I didn’t want to be doing CBT from 9-5.30pm, 5 days per week. I saw an advert for a job working in a University in Canada helping to run a Clinical Psychology training programme, applied for that, and have been in academia ever since. However, I still do clinical work, 1 session per week, and I really enjoy it. Continue Reading