Thrills and spills in Israel – Adventures of a PhD student – Philippa Fibert

The European Network of ADHD Conference took place this year in Tel Aviv, Israel, March 19th – 21st. It seemed like a good opportunity to present the results of my PhD pilot feasibility study assessing the effectiveness of treatment by homeopaths and nutritional therapists for children with ADHD, so I applied, and was accepted to do a poster presentation.

I was thrilled, but somewhat intimidated to then be asked to do an oral presentation in the non-pharmacological intervention symposium at the conference. The speaker list was littered with academics referenced in my thesis and I think I was the only non-doctor on the list. On my request, my ‘Dr’ prefix was removed from the programme, but it had crept back by the time the conference started.

As one of the co-authors, Professor David Daley from Nottingham University (who was chair of the trial steering committee) put it: you are speaking amongst giants.  My nervousness increased further when the symposium was moved from a small, cosy setting to the enormous hall where the plenary lectures took place, due to the popularity of the topic.

The title of my presentation was Rethinking ADHD Intervention Trials: Feasibility Testing of Two Treatments (Nutritional Therapy and Homeopathic Treatment).  During the presentation I discussed the importance of pragmatic trials to assess whether interventions might improve the long term negative outcomes associated with ADHD.  I also presented the pilot findings regarding the effectiveness of the two treatments tested using the Trials Within Cohorts (TWiCs) methodology developed by my supervisor, Clare Relton.

The majority of attendees were clinicians: psychiatrists, psychotherapists and psychologists. They told me that they appreciated the pragmatic nature of the design and assessment of the two interventions, since they attended the conference to receive practical information which might be helpful to their patients. I found myself unusual amongst the presenters in taking a more ‘public health’ approach to trials. The vast majority of ADHD research is conducted within Psychology departments, where pragmatic trials are rare, and more explanatory approaches the norm.

It is a significant tenet of my thesis that there is an unmet need for pragmatic trials of main and non-mainstream interventions for ADHD, to answer important questions as to whether treatments might improve long-term, negative outcomes. It was gratifying that clinicians agreed with me, and their enthusiasm is fueling my post-doc aspirations. But first I need to submit that thesis, and get through that viva………….

 

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Dr Liz Such awarded NIHR Knowledge Mobilisation Research Fellowship to explore how policy can be made healthier

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ScHARR Research Fellow, Dr Liz Such, has been awarded an NIHR Knowledge Mobilisation Research Fellowship for 4 years to help mobilise knowledge and conduct research about Health in All Policies. Her £200K award will support her development as a knowledge mobilisation specialist in the field of policy for health equity. The focus for the work will be on how local government policy, strategy and practice supports or constrains health promotion and equity.

This work takes place at an important time for local government. Financially, times are tough and there is growing recognition that the NHS and local public health departments cannot tackle health and health inequalities alone. Liz will be shadowing local government officials and council members as they seek to address local challenges – economic and social – whilst pursuing better health and wellbeing among local populations. She is particularly interested in how health is integrated into decisions and actions around ‘inclusive economic growth’ in local areas.

She will be conducting several packages of research and knowledge mobilisation activity with the support of mentors in the University of Sheffield, including Professor Elizabeth Goyder in ScHARR and Professor Sarah Salway in Social Sciences, the University of Edinburgh, UCL, the Health Foundation and Sheffield City Council.

For more information contact Liz at e.such@sheffield.ac.uk

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Understanding Stability and Change in British Drinking

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The Economic and Social Research Council (ESRC) have awarded £650,000 to Prof Petra Meier, Dr John Holmes, Dr Monica Hernandez and Prof Alan Brennan from ScHARR and Prof Alan Warde from the University of Manchester to investigate how and why British drinking culture is changing.

During 2001 to 2016, Britain experienced a historic peak and subsequent steep decline in alcohol use. There were a lot of things going on during this time – licensing reforms, a ban on smoking in pubs, debates about alcohol duty and minimum prices, media focus on ‘Binge Britain’ and ‘Ladette’ culture, and a new generation of young adults who rarely or never drink alcohol. Of course, there were also major macroeconomic and social shifts – first and foremost recession and austerity. Together, these influences are suspected to have contributed not only to a reduction in consumption but to fundamental changes in our drinking culture. However, so far these have been sparsely documented and poorly understood. For example, we know young adults are drinking some 40% less than a decade ago, but we know little about what has changed in terms of where, when, why, how or with whom they are drinking, and how drinking fits into their everyday lives. This limits our ability to provide expert commentary on how changes in alcohol use relate to wider cultural and structural shifts, to anticipate and respond to future trends in both alcohol use and related harm, and to inform public policy and debate.

By combining rich contextual market research data, new applications of theories of practice and sophisticated statistical analyses, the project aims to address these challenges and provide new quantitative insights into how Britain drinks. In particular, it focuses on investigating activities that involve drinking as social practices, reflecting the varied range of different behaviours and types of occasions that together make up the phenomenon “alcohol consumption”. The new insights will support the development of public health policy approaches that are targeted at disrupting problematic practices whilst supporting transitions to less risky drinking and non-drinking practices.

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Four key questions will guide our work:

  1. How did drinking occasions and their characteristics change from 2001 to 2016?
  2. What explains variation in occasions across population groups, between places and over time?
  3. What macro-level trends in alcohol consumption can occasion-level data help to explain?
  4. How did major societal and policy changes between 2001 and 2016 affect drinking occasions?

Petra says:

“My team and I are delighted to have been awarded this grant which we hope will shed light on how and why alcohol consumption has changed so dramatically over the last two decades. Recent reductions in consumption levels have been welcome news but only a thorough understanding of why they have occurred will allow us to lock in the benefits and transfer learning across to other settings or health behaviours.”


If you want to read more, three of the investigators have set out their thinking in a recent publication:

Meier PS, Warde A, Holmes J (2017) ‘All drinking is not equal: how a social practice theory lens could enhance public health research on alcohol and other health behaviours‘, Addiction, 113 (2), pp.206-13

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10th ECTMIH conference

Sarita Panday

Sarita presenting her poster entitled “Impact of community-level factors on the volunteers’ services in rural Nepal: a qualitative study”

Sarita Panday (SIID) and Julie Balen (ScHARR/SIID) recently attended the 10th European Congress on Tropical Medicine and International Health (ECTMIH), held in Antwerp, Belgium. Beyond presentations of their research from Nepal and The Gambia, Sarita and Julie reflect on what they gained from attending the conference, and what some of their main take home messages were.

ECTMIH is a biennial event that brings together scientists and experts from Europe and from all over the world, including a large proportion of delegates from low and middle income countries (LMICs), as well as many of the Emerging Voices. It is patronised by the Federation of European Societies of Tropical Medicine and International Health (FESTMIH). Both Sarita and Julie were impressed by the huge representation of countries and regions at the conference. There was a great diversity of scholars and research presented from Afghanistan to Zimbabwe, giving the conference a truly international flavour.

Similarly, there was a wide range and breadth of disciplines represented, including some in sessions that ran using rather innovative formats. Julie attended the Emerging Voices session entitled “Making Promises, Breaking Commitments: What is the Role of Health Policy and Systems Research in Transforming Political Commitments into Better Health Systems?”. The format of this session was an interactive debate with pre- and post-debate voting by the audience. Both sides put forward an impassioned and convincing set of arguments for and against the motion: “health policy and systems research (HPSR) has focused too much on evidence, blind to the fact that policy is about interests, values, power and politics, which has made HPSR largely irrelevant to the creation and implementation of political commitments”. The audience was fairly divided, and some even tried to vote for and against, seeing both sides of the argument.

Of particular interest to Sarita and Julie were the numerous sessions focussing on community engagement and participation, given the focus of the ESRC project 1 Sarita and Julie are both involved in, as well as Julie’s Global Health Trials funded study 2. Sarita will shortly be heading Nepal for fieldwork using video-voice methodology for data collection. Although no sessions focussed specifically on video-voice, there was a session entitled “The Power of the Image: Use of Multimedia in Health Research, Advocacy and Dissemination” which explored the use of photovoice to explore aspects of social inclusion/exclusion of children with special needs in Uganda. This session also explored use of video for advocacy and research, as well as agenda setting in the Indian health policy sphere.

Finally, one stimulating aspect of the conference is that all delegates were encouraged to attend at least 1 session in a different field or discipline to what they themselves work on. Indeed this kind of cross-disciplinary thinking was encouraged throughout the conference by ensuring that all the Opening, Plenary and Closing Sessions included speakers focussing on the basic science / clinical aspects of global health, as well as the applied science / implementation aspects of global health. Breaktime discussions with other delegates from a range of disciplines were aided by this kind of formal attempt at cross-fertilisation of ideas. We hope that future conferences continue to find ways of breaking down the silos that we all commonly find ourselves in. Overall, ECTMIH was a successful conference and Sarita and Julie represented Sheffield University, engaged with alumni, and met old and new colleagues and collaborators, whilst also presenting and gaining feedback on their research.
1 Resilience policymaking in Nepal: giving voice to communities (2017-2018)
2 Reactive household-based self-administered treatment against residual malaria transmission: a cluster randomised trial (2015-2018)

Written by Julie Balen & Sarita Panday

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New Year, New Students

We are delighted to welcome our new cohort of taught postgraduate students to ScHARR.

Students from across the globe have arrived today to study programmes in public health, management and leadership, health economics and decision modelling and clinical research.

We also welcome students to our online programmes. Although they may not be based in Sheffield, students studying international health leadership and management, advanced emergency care, public health or health technology assessment at a distance are equally part of the ScHARR community.

Intro Week 2017 student cohort

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ScHARR contributes to new report on liver disease and alcohol consumption

A new report published by the Foundation for Liver Research and endorsed by the Lancet Commission on Liver Disease includes new estimates from the Sheffield Alcohol Research Group (SARG) of the burden that alcohol places on the NHS and society. The report was featured on the front page of the Guardian newspaper on Monday 24th July, 2017.

SARG team

The figures used in the report come from the Sheffield Alcohol Policy Model, a complex behavioural and epidemiological simulation model which combines data on patterns of alcohol consumption and purchasing, current rates of harm for 43 different alcohol-related health conditions, evidence on the relationship between prices and purchasing, and epidemiological evidence on the links between drinking at different levels and risks of harm.

The numbers show that alcohol is estimated to cause 35 deaths and 2.300 hospital admissions a day in England, and over the next 5 years this will cost the NHS almost £17billion at a time when healthcare resources and budgets are already being stretched. This research also highlights the potential for policies such as a Minimum Unit Price for alcohol to reduce this burden.

This report comes out just as the UK Supreme Court is hearing the final stage in a lengthy court battle between the Scottish Government and the Scotch Whisky Association about the legality of Scotland’s efforts to introduce a Minimum Unit Price for alcohol.

Evidence from SARG and the Sheffield Model has formed an integral part of the court case, highlighting that the policy would effectively target the heaviest drinkers and have a positive effect on socioeconomic inequalities in health. The court’s judgement is expected to be delivered in the Autumn, with a host of other countries, including Wales and Ireland, looking on. Both countries have announced their intention to introduce a Minimum Unit price, supported by SARG modelling, however this seems certain to be conditional on the Supreme Court ruling that the policy is not in breach of EU law.

The report can be downloaded from the “Downloads” section on the right hand side of this page.

University of Sheffield press release.

Guardian article featuring SARG’s work.

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What is the public health role in modern slavery?

liz-suchDr Liz Such has been seconded to Public Health England to review the public health issues and knowledge gaps in the field of modern slavery. Early findings have identified the value of partnership working across all  sectors plus the importance of senior strategic leadership in tackling modern slavery. A summary of findings will be published before the autumn; there will be a poster presentation at the PHE conference, and a full report planned for October to coincide with national anti-slavery day.

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Nepal: Reconstruction, Resilience and Development. A One-Day Workshop

nepalThis workshop isn’t a ScHARR Public Health event; it is presented by our colleagues at the Sheffield Institute for International Development. It features Professor Padam Simkhada who is an Honorary Senior Lecturer at ScHARR.

DESCRIPTION

The massive earthquakes that struck Nepal in 2015 caused huge loss of life and widespread damage to property and infrastructure, from which the country is still recovering. This workshop brings together leading experts on Nepal to discuss the challenges that the country faced in the immediate aftermath of the earthquakes, and also the prospects for future resilience and development.

The morning sessions will be devoted to the presentation of papers. The afternoon will be made up of roundtable discussions on key issues in reconstruction, resilience and development.

Provisional programme:

10.00-10.10 Welcome from Dan Brockington, Director of the Sheffield Institute for International Development

10.10-10.30 Introduction and introductions. Simon Rushton

10.30-11.30 Panel 1:

Sapana Bista (Liverpool John Moores University) – ‘The disability sector’s experience of the Nepal earthquake during recovery, rehabilitation and reconstruction’

Sarah Galvin (PHASE Worldwide) and Jiban Karki (PHASE Nepal) – The experience of small NGOs

Padam Simkhada (Liverpool John Moores University) – Traumatised? I don’t think so! Mental health situation in Nepal after earthquake.

11.30-11.45 Coffee break

11.45-13.00 Panel 2:

Bibha Simkhada (Liverpool John Moores University) – Scope and importance of continuous professional development (CPD) training on risk reduction and disaster management in Nepal

Bhimsen Devkota (Tribhuvan University) – Education

Hanna Ruszczyk (Durham University) – The earthquake and ideas lying around.

Edwin van Teilingen (Bournemouth University) – Business as usual? Disasters, incompetency and corruption.

13.00-13.45 Lunch (provided)

13.45-14.45 Roundtable 1: Characteristics of resilient communities.

What made communities resilient (or not) through the earthquakes and reconstruction?

14.45-15.00 Coffee break

15.00-16.00 Roundtable 2: Developing resilient communities.

What are the challenges communities face today and in the future? What role can the national government and its international partners, as well as NGOs, play in mitigating these challenges?

16.00 End

All welcome. Please register for a (free) ticket by 13/7/17 so that we know the numbers for catering purposes.

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Join Us

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Opportunity for a qualitative researcher to join SARG: Sheffield Alcohol Research Group

Closing date Thursday 13 July 2017.

For more information, or to apply, see the Job Overview

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Join Us

People walking into the quad at ScHARRWe are recruiting a talented, effective social scientist with a strong interest in understanding and tackling the social determinants of health inequalities, particularly those linked to race/ethnicity and migration. Closing date 18.07.2017 Apply here.

 

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