Studies Within A Trial (SWAT) Workshop – Aberdeen, 23rd March 2017

I realised earlier in the week that I haven’t talked a huge amount about the other projects I’m involved with aside from my PhD work, so this week’s post is about a project linked, but not central to, my own research project.

Studies Within A Trial (SWATs) are smaller studies embedded within a host trial, largely they have the aim of investigating some methodological aspect of the way we conduct the trial. There are currently 46 SWATs listed on the SWAT repository, which mainly look at recruitment and retention of participants; the two most difficult parts of the trial process.

These types of study are notoriously difficult to get funding for, they’re often poorly understood by approvals and ethics bodies, and they tend to be the first thing to fall off the list of priorities for trial teams as they’re an ‘add-on’ – a bonus that’s not central to the aims of the overarching trial. On Thursday last week I attended a SWAT workshop led by my PhD Supervisor in Aberdeen. Other attendees included representatives from pharma, the National Institute for Health Research (NIHR), the Health Research Authority (HRA), researchers, clinicians, trial managers, patients and directors of UK Clinical Trials Units.

Our discussion was lively, wide-ranging and incredibly useful. We tackled the tricky aspects of how to gain approvals, how to get funding, and how to galvanise the trials community to embed the use SWATs in routine practice.

One thing that I found really valuable was the discussion with patient representatives; we had 2 ladies join us to give their opinions. They drew our attention to topics I hadn’t necessarily thought of before, and helped us work through how we might (or might not) explain this additional study to trial participants both at the beginning and end of the study.

Throughout the day I took lots of notes – scribbling away whilst different people were talking to ensure I didn’t miss key points. We ended up discussing how to make SWATs easier to do for around 6 hours so my pile of notes was pretty huge! Once I’d got home I read over my notes whilst the discussion was fresh in my head, and consolidated them into one side of A5.

I find this a really useful thing to do after a day at a conference or workshop – it helps me to summarise topics in my head and ensures I don’t just push my pile of notes to the back of my desk drawer to be forgotten about.
Does anyone else do this or is it just an excuse I’m making to get the best use out of my unhealthily large stationery collection…?

Getting involved with additional projects outside of the PhD has been so valuable for me – it’s helped to improve my time management skills, expanded my knowledge of health services research more generally, but most importantly it’s helped me build confidence. I really enjoyed the day, and found it useful to speak to people outside of my own little research group; we tend to agree on a lot of things so it’s refreshing to get a new perspective and be challenged on points I’d previously taken at face value.

Self-Care Tips to Keep You Sane: Podcasts

At the end of January I wrote about the importance of academic self-care for PhD students; I didn’t delve too far into the specifics of what I do in my downtime and a lot of people asked. ‘It’s hard to switch off’ and ‘I find it hard to relax’ were the two phrases I encountered most frequently, so I thought I’d introduce a series of posts that provide more information, and recommendations, on what to do to give yourself a break during the inevitable stressful periods that come with doing a PhD.

This week I’m starting with podcasts. I listen to podcasts daily; they help force my brain to focus on something that isn’t work, and they can be a really good way to spend the time you can easily lose when experiments are running or when you’re walking to/from the office. When looking for a new podcast to listen to I’m always a bit overwhelmed by the amount of choice available, so I’ve narrowed my favourites down to 4, and also given you a list of the 3 that are next on my ‘to listen to’ list.

What? Serial – Season 1
Who? Sarah Koenig, the people from This American Life, and a huge variety of guests linked to the case
What’s it about? Serial started the rise in podcast creation, it’s still the bench-mark for new pods to aim for, and it won a Peabody Award in 2015 for its innovative telling of a long-form non-fiction story. The first season investigated the 1999 murder of Hae Min Lee, an 18-year-old student at Woodlawn High School in Baltimore, Maryland. Her corpse was discovered on February 9th and identified two days later. The case was immediately treated as a homicide. Lee’s ex-boyfriend, Adnan Syed, was arrested on February 28th, and charged with first-degree murder. Syed’s first trial ended in a mistrial, but after a six-week second trial, Syed was found guilty of Lee’s murder on February 25th 2000, and given a life sentence.
A word of caution – don’t get sucked into Serial Season 2; it’s no where near as good as Season 1. Season 3 is coming later this year – fingers crossed it matches up to Season 1.
When? Season 1 aired in 2014 but all episodes are still on iTunes ready for you to binge!
Where can I listen? Listen on iTunes here, or on the podcast website here.

The creators of Serial have just announced a new podcast called S-Town, starting March 28th, which sounds amazing.

What Undisclosed – All seasons are brilliant, but season 1 is my favourite
Who? Season 1 – Rabia Chaudry, Susan Simpson, Colin Miller
What’s it about? Rabia Chaudry was the person who initially alerted Sarah Koenig to Adnan’s case, leading to Serial. After Serial Rabia didn’t feel as though Sarah had done enough digging, she knew there was more, so she got together with Susan Simpson and Colin Miller to take a closer look at the case through Undisclosed. Season 1 is a brilliant podcast for those who’ve just finished Serial Season 1, but Season 2 (Joey Watkins) and Season 3 (Freddie Gray) stand alone. It’s one of the most in-depth podcasts I’ve ever listened to, and I find myself thinking about it for days afterwards.
When? Seasons 1 and 2 are already on iTunes, Season 3 started on March 6th, updating Mondays and Thursdays
Where can I listen? Listen on iTunes here, or on the podcast website here.

What? Don’t Salt My Game
Who? Laura Thomas PhD, plus guests
What’s it about? Laura Thomas is a Registered Nutritionist and Wellness Advocate, she talks to people in wellness, foodies, bloggers, entrepreneurs from cool brands, nutritionists, doctors, and anyone else who is shaking up the wellness world, to find out how they stay on top of their game – and to help you do you, but better. It’s not all headstands and courgette though; she and her guests aren’t afraid to dig deep into the darker side of wellness and will call BS on weird and faddy trend that don’t have any legitimacy or scientific merit.
This is a refreshingly honest pod that focusses on evidence, avoids the usual airy-fairy Insta-nutrition we see from unqualified influencers, and straight up calls out weird stuff like putting coconut oil in everything. I love this podcast, it feels like you’re having a chat with Laura and her guests – you’ll learn a tonne and never feel patronised.
When? New episodes every Friday
Where can I listen? Listen on iTunes here, or on Laura’s website here.

What? Missing Richard Simmons
Who? Dan Taberski and whoever he can rope in to speak to him
What’s it about? On February 15, 2014, fitness guru Richard Simmons disappeared. He stopped teaching his regular exercise class at Slimmons, cut off his closest friends, and removed himself from the public eye after decades as one of the most accessible celebrities in the world. Nobody has heard from him – and no one knows why he left. Filmmaker Dan Taberski was a Slimmons regular and a friend of Richard’s. Missing Richard Simmons is Dan’s search for Richard – and the deeper he digs, the stranger it gets.
The thing I really love about this podcast is that everyone has a different theory of what’s happened/is happening. Amanda Hess reported in The New York Times that this is a ‘morally suspect podcast’ – others think Taberski is genuinely worried about his friend and is doing everything he can to find him. I’m not sure where I sit, I just really hope that at some point we get an updated episode with an appearance from Richard Simmons himself.
When? New episodes every Wednesday
Where can I listen? Listen on iTunes here, or on the podcast website here.

Podcasts on my ‘to listen to’ list:

  • My Dad Wrote a Porno – I’ve heard a lot about this podcast, everyone I’ve spoken to about it says it’s absolutely hilarious, but then they blush a little and the topic moves on..
  • The 45th – hosted by Rabia Chaudry (Undisclosed), and featuring Susan Simpson and Sarah Basha, this is a recently developed podcast that examines developments from the White House that are worth a second look.
  • The Minimalists – After watching the Minimalism film – a ‘documentary about the important things’ I’m really intrigued by this, it’s next on my list once Missing Richard Simmons finishes next week.

Are you an avid podcast listener, are there pods I’ve skipped entirely? Leave a comment or Tweet me your recommendations!

Women in STEM: Events, Challenges – and Why?

I haven’t touched on any political or religious topics on this blog, I haven’t spoken about money or what I think of Donald Trump, and largely I think people believe that feminism belongs in that same pile of topics you-just-don’t-talk-about. I don’t agree.

Feminism is important, and the process of explaining my views, beliefs and actions to help support other women, especially in the scientific community, is necessary. So this week’s blog post is going to be a bit of a brain dump of thoughts inspired by events and conversations over the past week – the week of International Women’s Day. I hope it ends up being a cohesive piece about why supporting women in STEM subjects (Science, Technology, Engineering and Mathematics) is a positive and useful thing to do, rather than the feminist rant that’s in my head.

Let’s start with some nice news:

This week I was told I’ve been accepted to take part in Soapbox Science‘s Edinburgh event this July. In their own words: “Soapbox Science is a novel public outreach platform for promoting women scientists and the science they do. Our events transform public areas into an arena for public learning and scientific debate; they follow the format of London Hyde Park’s Speaker’s Corner, which is historically an arena for public debate. With Soapbox Science, we want to make sure that everyone has the opportunity to enjoy, learn from, heckle, question, probe, interact with and be inspired by some of our leading scientists. No middle man, no powerpoint slide, no amphitheater – just remarkable women in science who are there to amaze you with their latest discoveries, and to answer the science questions you have been burning to ask.

I’m going to be talking about clinical trials – why take part in a trial, how participation might be beneficial, and what happens if not enough people take part in clinical trials. It’s not designed to be a propaganda piece, or a talk to try and get people to take part in trials; just an opportunity for me to talk about the work I do and the reasons why I think it’s important, and a chance for members of the public to ask questions and take part in a discussion. There’ll be 11 other women scientists there talking about their own work, and I’m really looking forward to learning about what they do too.

And an online engagement activity for women in STEM:

This month, The STEM Squad are running a photo a day challenge on Instagram – take a look at their Instagram account here. In their own words, they are “An inclusive community of femme-identifying STEM professionals and enthusiasts“. The challenge involves people posting a photograph each day for the whole of March (including #WEARESTEMSQUAD), with the aim of showing the many sides of women in STEM. As I write this it’s currently day 10 and I’ve managed to keep up, I’ve really enjoyed seeing everyone’s posts and following what they get up to each day. It’s so cool to see what every does, how different each career is, and what we all like to do outside of the labs/offices/fields that we’re in day-to-day.

The themes covered in the Instagram challenge are in the picture above, so take a look at the hashtag and join in if you haven’t already!

I was talking to a friend earlier on in the week about the Soapbox Science event and The STEM Squad challenge, and she (very innocently) said, ‘Why is it just for women though? That seems a bit unfair.’

My initial response was to be a bit stroppy – why does every event that involves only women get the whole ‘why not men?’ argument thrown back at it, why can’t we just do stuff as a group of women supporting each other?! The more I thought about it, the more I calmed down. Maybe women in STEM get this weird backlash because people don’t understand the point of why we’re doing these events, these public engagement activities and challenges online. I figured this was a good place to talk about it (Twitter was out because of that time I tweeted about a BBC Three documentary called Men At War and got trolled for at least a fortnight ).

Women are not represented equally in the STEM workforce, in fact the percentage of women in science professional occupations dropped from 50% in 2015 to 41% in 2016. That gives a slightly skewed picture though; 41% isn’t so bad, right? Perhaps, but that 41% isn’t consistent across the board:

  • Only 18% of people in ICT professional occupations are women
  • Only 8% of people in Engineering professional occupations are women
  • Only 14% of people in management positions in Science, Engineering and Technology are women

Being a woman in STEM is not easy – personally I’ve people who are shocked when I say I’m doing a PhD, ‘but you’re blonde!’ like, really? I’m pretty sure that my hair colour has no relationship with my intelligence (feel free to correct me with a methodologically-outstanding randomised trial). Largely though, I haven’t experienced any sort of discrimination at all, just a whole host of supportive and brilliant colleagues with a view weird comments thrown in.

For others though, being a woman in STEM is really tough, and the comments and discrimination women receive puts them off being in STEM altogether, there’s a genuine gender wage gap, and there’s even research to show that women who work in male-dominated workplaces experience heighted levels of interpersonal, workplace stressors.

It’s important to even this gender imbalance out and create equal opportunities for both men and women. Doing events and drawing attention to the problem is one way to try and push that process forward. Creating a positive and welcoming environment for people to learn, ask questions, and actually see what women in STEM look like (see also #actuallivingscientist and #dresslikeawoman), can make a real difference for the next generation of STEM workers.

#365papers February Update

In my first post on this blog, I set myself 3 PhD-related goals for 2017. One of those goals was to read more widely, and more frequently, and I decided that doing the #365papers challenge would be a good way to do that.

Here’s my February update. I found this month a big more difficult than last month – time just seemed to go much faster so and I was missing days quite regularly, meaning I was reading 4 or 5 papers at a time in order to keep up.

February’s reading:

  1. Making doubt generative: rethinking the role of doubt in the research process
  2. Chocolate bar as an incentive did not increase response rate among physiotherapists: a randomised controlled trial
  3. Presenting the results of Cochrane systematic consumer audience: a qualitative study
  4. User experiences of evidence-based online resources for health professionals: User testing of The Cochrane Library
  5. User testing and stakeholder feedback contributed to the development of understandable and useful Summary of Findings tables for Cochrane reviews
  6. RevManHAL: towards automatic text generation in systematic reviews
  7. Developing a survey of barriers and facilitators to recruitment in randomised controlled trials
  8. Enhancing the reporting of implementation research
  9. Making mindset matter
  10. Multilayered and digitally structured presentation formats of trustworthy recommendations: a combined survey and randomised trial
  11. Can patient involvement improve patient safety? A cluster randomised control trial of the Patient Reporting and Action for a Safe Environment (PRASE) intervention
  12. Staff experiences of closing out a clinical trial involving withdrawal of treatment: qualitative study
  13. A systematic review of discontinued trials suggested that most reasons for recruitment failure were preventable
  14. Cohort profile: the Scottish Research register SHARE. A register of people interested in research participation linked to NHS data sets
  15. Understanding pragmatism and PRECIS-2
  16. Sex can affect participation, engagement, and adherence in trials
  17. Communicating with participants during the conduct of multi-center clinical trials
  18. Models and impact of patient and public involvement in studies carried out by the Medical Research Council Clinical Trials Unit at University College London: findings from ten case studies
  19. Decision aids for randomised controlled trials: a qualitative exploration of stakeholders’ views
  20. Participant retention practices in longitudinal clinical research studies with high retention rates
  21. Application of Incident Command Structure to clinical trial management in the academic setting: principles and lessons learned
  22. Publishing protocols for trials of complex interventions before trial completion – potential pitfalls, solutions and the need for public debate
  23. Design of case report forms based on a public metadata registry: re-use of data elements to improve compatibility of data
  24. Understanding variations in patient screening and recruitment in a multicenter pilot randomised controlled trial: a vignette-based study
  25. Risk of selection bias in randomised trials: further insight
  26. Assessment of clinical trial participant patient satisfaction: a call to action
  27. Stakeholders’ views on the ethical challenges of pragmatic trials investigating pharmaceutical drugs
  28. Financial considerations in the conduct of multi-centre randomised controlled trials: evidence from a qualitative study

Are any of you attempting to read #365papers this year? If you have any papers you’d recommend I read please leave them in a comment below.

The First Year of My PhD: Advice For New Starts

A few weeks ago I was asked to give a short talk at one of the University of Aberdeen’s Postgraduate Research Student Induction sessions entitled ‘The First Year of My PhD’. It’s a short session for new postgraduate researcher students across all disciplines within the university, with the aim of demonstrating how varied PhD experiences are, as well as sharing a few helpful hints and tips on what new starts should expect over the course of their first year of study. It takes  place next Tuesday so I figured this was a good time to get my thoughts in order. Hopefully some of you will find this useful – if you have any burning questions please let me know so that I can add answers in to my talk too!

So, a few things I learned during my first year of the PhD:

Getting your head around the project takes time
PhD advertisements usually include a basic outline of what your Supervisors see you doing, but the project should be yours. You’ll be the one ranting to your best friend at 10pm because your approvals haven’t come back and you need to get started with data collection – so it’s useful if you feel a sense of ownership over the project. Spend the first few weeks, if not months, getting to grips with what the project looks like; where it fits in with the current literature, and what you need to do to get it going. At the beginning I wrote a PhD protocol. It wasn’t anything formal, but it forced me to look at the big picture.

Building brownie points is really important
A PhD is a big coordinated effort with you at the core doing the majority of the work. For example, for my systematic review (protocol here) I wanted to do abstract screening, full text assessment, data extraction and risk of bias assessment all in duplicate. That’s a huge amount of work for one person, so finding someone to be my second was sometimes tricky. Of course Supervisors always offer to help, but they’ve got enough going on and it’s a good idea to get other researchers involved too. In come the banked brownie points! Offer to help out on other projects, do some abstract screening for another student, or write up minutes of meetings – integrate yourself into your team and you’ll find it much easier to ask for help when you need it later down the line.

Don’t be intimidated by the phrase ‘you’re doing a PhD’
Just after I started the PhD I was in the pub with some friends, someone asked what I did and I told them I had just started a PhD. They acted like I’d just told them I’d won the Nobel Prize for Chemistry – ‘Woah, you must be so clever!’ – this was coming from a qualified paramedic, i.e. someone who regularly saves lives. In comparison to my office-based daily activities of reading, writing and interviewing that seems a bit crazy to me. I thought about it for too long and started to doubt whether I was good enough to do a PhD – maybe I wasn’t clever enough? A word of advice, a PhD is more about resilience than intelligence, so just keep going and don’t fall into the trap of being intimidated by the process. More about so-called Imposter Syndrome here.

Little victories will keep you motivated
Some parts of the PhD take a really long time – I’ve currently been working on my systematic review for 15 months and I’ve only just got to the interpretation bit (i.e. the fun bit). It’s important to set yourself realistic goals over the course of the PhD so that you stay motivated throughout. I’m someone who write lists for everything, so each morning I write a list of things I want to do that day, and as a rule I don’t leave the office until that list is complete. These daily lists keep me on track and feeling like I have a purpose, even when the projects are long and can sometimes feel never-ending.

phd-comics

Manage the expectations of the people around you
I have a few friends who are also doing PhDs, but the majority of the people around me have no idea what I do each day – sometimes my Mum genuinely asks me if I’m going to school that day (Yes, really. I’m 25 and she still calls it school.). Anyway, there will be times throughout your PhD where you have a bit of a meltdown – this undergraduate dissertation hand-in day multiplied by at least a hundred. Explain to your friends/family/partner/dog etc that you’ll probably be a bit of a nightmare to be around every now and again for the next 3 years or so – do this at the beginning of the process and they’re much less likely to want to smother you when you wake them up at 3am because you’ve lost your USB stick. (Disclaimer: They might still want to smother you, but at least you’ve warned them early on in the process and you can use the phrase ‘I told you I’d be a nightmare’).

What advice would you pass on to new PhD students? Leave a comment and share your experiences!

A Trip to Oslo, Norway – February 2017

Travelling is something that I’ve always loved; I get itchy when I don’t have a trip booked – whether that’s to a new city, country or continent. I enjoy exploring new places and new cultures, and I knew that I’d like to take as many opportunities to travel from the day I started my PhD. I’ve always been clear with my Supervisor that travel is on my agenda, so both he and I can keep an eye out for opportunities/conferences etc further afield.

So far the travel aspect of my PhD hasn’t been super exciting – I’ve spent a lot of time in various cities around the UK, but no where further. That’s been fine with me though, I’ve used my holidays to explore different places instead, so far travelling to: Denmark, Thailand, Iceland and Austria. PhD-wise though, at the beginning of this month I was given the opportunity to travel to Oslo, Norway for a few days – hoorah!

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If you’ve never been to Oslo, I would really recommend that you do. I was a bit nervous before I went because I have never travelled to a non-English speaking country alone before, it turns out Norway is not exactly non-English speaking! The country is essentially bilingual; every time I asked if someone spoke English I was greeted with the response, “of course I do, how can I help?”. Travelling around Oslo was also incredibly simple, the metro system, buses and trams all seemed to work seamlessly. They were always on time, super clean, and very easy to navigate.

Aside from the practicalities of getting around, Oslo is such a cool place to be. After 3 days of meetings and work-related activity, my boyfriend flew out so that we could spend some time exploring Oslo together. We had such a good time! Earlier in the week everyone had been saying how awful the weather was, it was -4 degrees C and snowing on and off, but compared to Aberdeen which is often grey and rainy, the snow was a welcome change.

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So, why did I go out to Oslo in the first place? The trip was part of a project funded by a grant we received from the Chief Scientist Office (CSO) of Scotland last year. The project is the core of my PhD work, and aims to find out how trial teams are currently doing trial recruitment, what sort of evidence researchers need to design effective trial recruitment strategies, and how that evidence should be presented to them.

I met with colleagues at the Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), and the Norwegian Knowledge Centre for the Health Services (Kunnskapssenteret), to talk about trial recruitment experiences and issues, and tools and resources that might help. The individuals I spoke to were all hugely welcoming, helpful and enthusiastic about my work – I came home feeling excited to get back to my desk and get my teeth into this PhD again. Since I came back on February 6th I’ve Skyped with a few more members of the team out in Oslo, and again they’ve been brilliant! Over the next few weeks I hope to continue to collaborate and build relationships with the team, particularly at the Norwegian Knowledge Centre for the Health Services; my research and interests align with the team there most closely.

If you’re in the process of PhD study, I’d really recommend that you try to integrate some travel into your work. Personally I think it helps with motivation and enthusiasm for your own work, but more importantly it undoubtedly strengthens the work you’re doing. Speaking with new people gives new insights into the work you’re doing, can make you think differently about the way you conduct your research, and ultimately ensures that the results of the work you’re doing have a greater impact on the research community around you.

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