Little legs

Posted by Linda Penn

I was pleased that the train arrived to take me to Middlesbrough on a freezing January morning, although not so pleased that it was the cold train (heating in this train hasn’t worked for months). By the time I got to Middlesbrough station I was frozen through. Claire picked me up and took me to an annex at the back of what used to be St Cuthbert’s church. In this very cold and rather dark annex was a ‘community gym’ and I was there to interview South Asian women about their physical activity, as part of the evaluation of our preventive intervention feasibility study. By then I was so cold I would have preferred to tramp the treadmill to warm up or maybe even indulge in beginners’ Zumba. However, when the women started talking I forgot to be cold. Qualitative research can be such joy.

St. Cuthbert's Church, Middlesbrough, 1965

St Cuthbert’s church used to be near my uncle’s butchers shop, until the planners bulldozed the community to drive a road through the heart of the town and move people out to a concrete desert. I didn’t know, until my cousin told me recently, but they had apparently sold halal chicken from this shop. So there must have been a Muslim community in Middlesbrough for some time.

My great aunt Minnie’s sweet shop was also somewhere nearby St Cuthbert’s. I think she ran the shop from the front room of one of the little terraced ‘slum’ houses. This house too has long since been reduced to rubble. I only remember going there once and I was very young. Minnie was too old then to keep shop and my sister and I had been warned that Minnie had ‘little legs’. We were not to ask or comment. In fact, we should just pretend we had not noticed. The legs were not at all obvious when we arrived as she was sat in her big chair by the fire, with a rug over her knees. However after a while she got up to fetch the coal from the back kitchen. When she got up she was walking on her knees – the little legs. It was a shock, which must be why I remember. Nevertheless Minnie managed to negotiate down the stone step into the back kitchen to fetch the coal and obviously back up the step with the bucket of coal. I remember watching her. I am sure someone would have offered to go and get the coal for her, but she must have refused with such determination that no-one dared interfere. 

St. Cuthbert's Church, Middlesbrough, 2008

Not until years later did I appreciate that Minnie’s little legs were as a result of diabetes related amputations. That was my first introduction to the nasty, progressive and debilitating disease that is diabetes. It was pure serendipity that this January I was back almost where I started and the prevention message is the same. Although I hope the prosthetics have improved.

Class of 2002

Editor's note: On Thursday 14th March 2013, Newcastle University are hosting a celebration in honour of the 25th anniversary of their MSc in Public Health & Health Services Research. This post was prompted by requests for reflections from past and present staff and students on their MSc experiences. 

Posted by Linda Penn

My class all started the MSc course in 2002 and graduated at different times, so for me it was the class of 2002. The first day I was terrified, these were all ‘Health’ people and I was not. Also it was more years than I care to admit since I had taken any exam. Professor Nigel took the first session and it couldn’t have been a better start. His kind professionalism included all the stock in trade responses for encouragement: “Good point” (staggeringly obvious to anyone who has spent more than 5 minutes in research, but not entirely stupid for a greenhorn), “That’s interesting” (you have probably missed the point, but I will explain it more clearly and it is better if you do ask because other people will have missed the point as well).

After the first day Cath organised the coffee club and it all became rather more comfortable. Then there was Health Economics. I quite enjoyed this subject, but it was allocated to the post lunch ‘graveyard’ slot and a few students were inclined to sigh. One student decided to liven it up, but that is their story. I was shocked.

My anecdote is around prescribing antibiotics (or rather not prescribing if unwarranted). Lecturer X developed a long and complicated story about a mother demanding of a GP that he would prescribe antibiotics for her child who had a cold and a sore throat. This went on and on and eventually (in the story) this poor inexperienced GP gave in and signed the perhaps not entirely appropriate, although probably not life-threatening, prescription for antibiotics. Lecturer X pressed us about what we would do at the end of surgery (if we were this poor, unfortunate, misguided, bedraggled GP). Several people suggested various options, “Yes and?” said Lecturer X, quite a few times. Now I had come from a practitioner land where beautiful theory and immaculate plans regularly crashed on the rocks of circumstance and reality and where a good practitioner would have a sleeve full of contingency rafts, but would not take on board too many ‘perhaps ifs’. In naivety I decided that the story Lecturer X was pressing must be a message about conflicts between ideal and real along the lines of “if you don’t look after your-self you can’t look after other people.” So I suggested that this poor GP should go home and have their tea.

Southwesterly Gale, St. Ives; Frederick Judd Waugh

I was wrong. Lecturer X put their hands over their head and curled up on the floor to emphasise how wrong. I kid you not. (The ‘right’ answer was look up the Cochrane review for guidance. The message was about learning from mistakes). If the floor had opened up just then my red face and I could have happily slotted through.

However, what was really nice was that afterwards quite a few of my student buddies took the trouble to come up to me and say, “You were right” or, “You had a point”. So I remember acceptance, not embarrassment. I don’t expect anyone else will remember at all. Usually I limit reminiscence, but a reunion is the perfect excuse for a reminiscence fest

Playing in the sand: the joys of peer pressure

Posted by Peter van der Graaf

Have you ever wondered what would happen if you put 28 stressed-out early career researchers in a country hotel and gave them the option to either enjoy the available swimming pool, spa, snooker room, and pub with sun soaked terraces, or to write a full research proposal of up to 5,000 words with five unknown people in less than four hours and submit their work for scrutiny to a hard-nosed review panel of senior academics and professionals? Remarkably, when Fuse tried this out last week in the Sandpit event at Linden Hall, the result was five serious proposals, steeped in blood, sweat and tears, that somehow managed to persuade the review board to part with £2,500 of prize money.

The distractions were plentiful: giant Jenga, Connect4, indoor cricket, extensive breakfast and lunch buffets, (attempts at) nouveau cuisine diners, tough pub quizzes presided over by quiz-wizard communications officer Mark, log fires with arm chairs, and more coffee, tea and cakes than was healthy to consume, while hero professors bared all (at least their life stories) under large glass chandeliers. In spite of all these temptations, the researchers locked themselves up in their rooms, questioned the wisdom of their mentors, cross-examined policy and practice experts on their chosen subjects, argued and quarrelled at length with each other, and somehow managed to produce something that could pass for a research proposal.

Nerd peer pressure

The secret, you might wonder, is a classic tale of peer pressure, which early careers researchers are especially prone to. What the event allowed them to do was to learn this lesson (and many others in the course of it) and, even better, to enjoy it: a relaxing swim or pint in the pub is much more enjoyable after a chaotic session with five strong minded colleagues who are trying to reach a decision on what topic to choose for their proposal (only to find out later that they were allocated their third choice). A quiz or game of Jenga seems all the more exciting after struggling for three hours to put anything on paper, only to realise you have an hour left to write the remaining 5,000 words.

Therefore, a big thank you is in order for the organisers of the event, particularly to Avril, who had to miss out on many of the temptations due to a sudden bout of flu, and to quizmaster Mark, who clearly has too much free time on his hand to come up with the questions he did.

The Sandpit. Why Fuse is unlikely ever to overheat

Posted by Heather Yoeli 

At primary school in Melbourne, we learned about the Katherine School of the Air, which connects and educates children across the 500 000 square miles of the Northern Territory, which is the least developed and most sparsely-populated region of the Australia. For most of the year pupils and teachers communicate solely via satellite and internet technology, but when it’s not too hot they all meet together for swimming and teamwork-type activities. Fuse connects and educates across the North East of England which, though a mere 0.0016% of the size of the Northern Territory is the least developed and most sparsely-populated region of England and is, by overcrowded English standards, relatively remote – and in any case, Fuse members do much of their getting-together and collaborating and socialising online, too. However, Longhorsley is located at the same latitude as Novosibirsk in Siberia which means that, despite the Gulf Stream, this week’s Sandpit event was never going to be remembered for its warm evenings.

School of the air

I thoroughly enjoyed every aspect of the three days of the Sandpit. I enjoyed meeting people from across the region and I learned a huge amount from encountering research projects and perspectives and standpoints from across the vast expanses of public health theory and practice, being again reminded how incredibly broad a field public health can be. I loved the warmth of the conviviality of all those email addresses who suddenly transformed into faces and certainly. I loved the spark and sparkle of heated debates which energised and illuminated our groupwork. And I thought that the hot meals and heated spa were wonderful too. But it was nevertheless rather brisk, slightly chilly and somewhat requiring of more clothing than one might usually wear indoors.

And so I would propose that next year’s event ditches the name ‘Sandpit’ and rebrands itself as the ‘Snowdrift’ or ‘Ice sheet’, especially given that one of the projects undertaken was a research proposal into using the telephone to address the problems of cold-weather related winter deaths. Maybe it would attract funding from a refrigeration firm or the Alaskan state government. Maybe we could work on projects around the public health aspects of hypothermia and fuel poverty. Maybe we could have an ice-sculpting competition instead of the pub quiz.

So now that my fingers are warm enough to type, I’d like to thankall of the Sandpit organising committee as well as my fantastically knowledgeable, hard-working and thoughtful team members Emily, Karen, Sandra, Lynne, Leanne and Shelina. And thank you to the senior people in Fuse and the NHS who agreed to and funded the event. Please do please forgive me for taking the mick out of the temperature. Given that turning the thermostat up was the main suggestion offered for improving the event, you can be confident that you have really done something very, very right.

The day the media circus came to town

Posted by Jean Adams

Is it more scary when Monty Don slags off your research on Twitter, or when a professor who you respect a lot asks you nicely to be a bit more careful with your not-quite-what-it-was-designed-for use of his carefully developed tool (also on Twitter)? How about both on one day?

What seems like a long time ago now, an MSc student emailed to ask if I’d be interested in chatting about an idea he had for a dissertation project.

His idea was simple: compare the nutritional quality of ready meals to celebrity chef meals. I don’t think the student (now graduate) in question would mind me saying that he’s not unfamiliar with a ready meal, or currently maintaining his weight within the recommended BMI range. Slightly fed up with being told his ready meal habit was bad for him, he was interested in finding out just how bad and whether it was any worse than the alternative that seemed to be in his face whenever he was eating his ready meals – something served up by Nigella, Jamie or Hugh.

In contrast, I and my co-supervisor were backing the celeb chefs. I don’t think I’ve ever eaten a ready meal, and it is possible that I have an affinity for glossy recipe books that has resulted in a collection that outgrew the kitchen bookcase some time ago. Scientists are neutral (not). We might be able to collect and analyse the data objectively, but it was clear what results each member of the research team was hoping to find.

The project was perfect for an MSc dissertation: clear research question, data collection primarily via the web, fairly straightforward analysis, no ethics permission required. We joked in supervision that the BMJ would love it.

And so it came to pass that the student collected and analysed his data, perhaps stretched the use of front of pack labelling for a good gimmicky visual a bit too far, got a good mark, and toddled off back to his real job promising to send us a draft of a paper sometime. Often those manuscripts never materialise. But lo! This one did. I wasn’t absolutely convinced that the BMJ really would love it, but we’d said they would and it seemed a shame not to try. They say ‘no’ pretty quickly.

I was mildly offended when the BMJ’s response to our rather serious and important piece of work was that it was “quirky” enough for their Christmas edition. Sure it was fun and sure I wasn’t quite convinced that it was good enough piece of work to be considered normal BMJ material. But there is a serious point here: lots of public health advice suggests that people should cook from scratch and implies this is better for you than eating ready meals. If you don’t know how to cook from scratch, then it isn’t a wild assumption to suggest that you might learn from the most prominent cooks around – celebrity TV chefs. A nutritional comparison of the two doesn’t seem outrageous.

Presumably you know what our findings were? We found that, on a number of nutritional metrics, ready meals did better than celebrity chef meals, but neither of them did very well. The ready meals were less unhealthy than the celeb chef meals, but it would probably not be right to say the ready meals were healthier than the celeb chef meals.

I knew what was going to happen. I didn’t have any idea how to stop it happening. Perhaps there was none.

The BMJ went to town promoting our paper. The media loved it. We got on the Today programme headlines, the paper was covered by loads of newspapers and not just in the UK, all three of us spent most of publication day doing interviews with just about everyone and their dog. But however much we tried, it was very difficult to get the message across that neither group of meals were particularly good for you – we were definitely not saying that ready meals are the way to go. But that’s the message that everyone seemed to hear.

Ho hum. What can you do? The media circus would move on. No-one would remember. And presumably any colleagues who would, might take the time to read the paper (or at least the abstract), and not just go on what was in the newspapers?

I can understand why people went for the “ready meals healthier than celeb chefs” headline and why that then prompted all the various responses it did. But I was most bothered by Monty Don’s response. And not just because I’ve always thought he seemed like a nice, and thoughtful, guy.

Do lots of people think scientists should only do, and publish, studies that come up with the ‘right’ results? That we should make sure the measures we use are designed to come up with those ‘right’ results? What about Ben Goldacre and the All Trials campaign for open data and publication of all trial results – not just positive ones? How does that match with this attitude? Or maybe I’m assuming that Monty is more representative of ‘the public’ than he really is.

Ignoring the ‘experts’ and sticking with the hard to follow guidance as a mom

Posted by Liane Azevedo

Being a Mom has changed my research interests. Now, every time I see something related to physical activity, diet or even sleeping behaviour in early childhood it grabs my attention.

However, I must confess that it is not always easy to follow the public health recommendations that are set for moms on how we should raise our children. More important, I think, is to fight against the pressure that you receive from family, friends and sometimes complete strangers to follow their guidance.

For me this started with breastfeeding. Being born in Brazil where breastfeeding is the rule rather than exception, I have never considered any other option. However, I must say this hasn’t been an easy process. I faced several challenges including mastitis, bleeding, and the fact that my son woke every hour during the night to breastfeed. As soon as I mentioned these problems to other people the first advice I received was, “Give him a bottle.” But I don't want to give him a bottle. Then you’re told that your milk must be weak, which is why he is waking up every hour and so on... (Note: my son was born on the 50th percentile and after 4 months he was on the 90th just with breastfeeding). 

Pieter de Hooch: Mother nursing her child, c1674 

People appear to want to impart their ‘expertise’ on every phase of his development. They say: “Why did you let your child feed himself? Now he is a fussy eater and look at the mess he does! Look at my son he is 2 and I still feed him and he is not a fussy eater”. Then when it comes to sleep they suggest the use of techniques such as ’control crying’, in which you let your child cry until he/she settles down. Being a very soft mom (I know I will pay for this later in his teenage years), I can’t cope with this idea. Luckily, I found some scientific evidence to support my decision (you can always find what you want to, when you search for it). According to this paper “Leaving an infant unattended and in distress, advocated by many clinicians, is not the only efficacious method by which sleep consolidation can be achieved and may not be either necessary, ethical or biologically sound.” It basically says that crying is the way a child communicates with its parents and by ignoring it, you will be blocking this communication. So, that will do as justification for me.

This all reminds me of a presentation I saw recently at the North East Physical Activity Forum, with the intriguing title: “Why we should shut up about the long-term benefits of physical activity”. Although the presenter didn’t give any scientific evidence to her comments, the main message was that long-term benefits of physical activity cannot persuade people to start physical activity. So, we should advocate the short-term benefits such as “have more energy”, “sleep better”, “meet people”, and “reduce anxieties, worries and depression”. I don’t necessarily agree with her comments, probably because I work in this field and the long-term benefits strike me more than the short ones. But this might be worth investigating. However, if I decided to look for the short term-benefits on how to raise my child, I would probably be doing everything against the recommendations. Don’t breastfeed, let him cry himself to sleep, and leave him in front of the TV so you can have your own time. I’ve learnt that sometimes you need to stick with hard to follow guidance to see the benefits which, might take a while to show but, are much more important than the immediate comfort that you would probably get from not following them.

Time management

Posted by Lynne Forrest

I constantly worry that I’m not spending enough time on my PhD. When I hear of other people who work weekends and do 60-hour weeks then I definitely feel that I’m not putting enough hours in. I struggle with fitting a full-time PhD around all my other life-commitments. And I worry that this makes me look like I’m not taking it seriously, when I definitely am.

I’m lucky enough to be a full-time, fully-funded PhD student and I’m totally in awe of those people who are fitting in a PhD around working. I really don’t know how they do it. It’s hard enough to find enough hours in the day without having to juggle a job as well.

I presume that if my supervisors thought I was skiving off, they'd have said something by now

Prior to the PhD I worked part-time whilst my children were little. So the switch to a full-time PhD commitment was initially a bit of a culture shock to everyone. I was no longer able to attend all the school plays, concerts and sports events I used to and my children did guilt-trip me with this. Once everyone had adjusted their expectations it became manageable.

When I started the PhD I decided to give up my gym membership as I couldn’t find the time to go. However, as I spend most of my working day sitting down analysing data I found that the weight was creeping on, so this was probably not the best idea. So I’ve decided I need to fit exercise back into my life – I’m just not quite sure how I’m going to manage this. I’m currently experimenting with going running and am in the early, enthused stage of taking up an exercise regime. So when this wears off it can give me something else to feel guilty about. When I’m exercising I can worry about not doing enough hours on the PhD and when I don’t get round to exercising I can feel bad about that too….

A couple of days a week I finish at 4pm to do the school pick-up and encounter the usual guilt as I furtively sneak off early out of the office. I do a further hour or so when I get home but this can be regularly interrupted and so isn’t ideal. I actually find working from home really difficult as it’s too easy to become distracted by all the domestic drudgery that needs done. I prefer to work in the office and, even though I have to factor in travel time, I’m definitely much more productive. To maximise work time I just eat a quick lunch at my desk and do sometimes feel I’m missing out on being more sociable, but I really can’t spare the time.

I am aware how lucky I am to be able to work this flexibly and I know how much more difficult it is outside academia. In one of my (many!) previous jobs I worked as a computer programmer for a large Scottish bank. All staff had to clock in and out and, although there was some flexibility, a core 7 hour day had to be worked. All time spent on a project also had to be logged weekly under different headings and I really hated having to account for every hour in this way. I love the flexibility of academia where, within reason, you can spend as long as you need on a task without your every action being scrutinised.

Anyway, I presume that if my supervisors thought that I was skiving off then they’d have said something by now. As it is, my PhD does seem to be going pretty well. As much as possible I’ve attended conferences, done external training courses that have meant staying away for days at a time and have also tried to get involved with other aspects of the Institute where I work. But I’m aware that other people are in earlier and work later. I just have to keep reminding myself that it’s quality not quantity that counts. And that I’d be worried if I didn’t have something to worry about…

Oh, you’ve been playing in the Sandpit again?

Posted by Avril Rhodes

When you mention to colleagues or to your nearest and dearest that you’ve spent your working day going around country hotels trying to find the best venue for the Fuse Sandpit residential training event some really sceptical looks are forthcoming. They don’t say it, but each is thinking “What a waste of time – hasn’t she anything better to do?” But, honestly, it really is hard work.

When M’Lord was building his country seat, he thought about creating spectacular grounds, rooms for an army of servants, stable blocks, fine dining rooms and a grand entrance. Strangely, he did not think about the post-aristocratic world of conferencing, or even imagine electricity and internet access. Consequently, whilst ambience, embossed wallpaper, log fires, wonderful views, and curtains that could be turned into seven man (sorry, person) tents are there in abundance, they do not necessarily make for suitable workshop or break out rooms. Country house eccentricity, whilst good for life-size Cluedo (was it Professor Plum in the drawing room with the digital projector or Research Assistant Scarlett in the library with the flip chart?), doesn’t always readily adapt to one’s conference needs.

The final decision: Linden Hall

Some of the country hotels adapted for conference purposes seem to have lost their individuality. The brochure might show a glorious Adam frontage or Palladian columns, but your event mysteriously turns out to be in a windowless, purpose-built block with polystyrene roof tiles, refreshment points (read rubbish coffee machines) or in a wing that separates you from other patrons as if you were somehow infectious.

Never mind, these monstrosities shouldered aside, we have a lovely venue which oozes individuality and charm. Now to envision our use of the space… Yes - the lounge makes a good plenary room, until you realise the public are going to troop through to the dining room. Yes – the library makes a good workshop, until you realise that it only has one socket. Yes – the so-and-so suite would be good until you realise that it’s the wrong shape or size, or might be cold, or doesn’t have enough clear wall space, or is miles away from the other workshop rooms. Debates break out like, “Well, if we use room A for B and space D for C, then we could use room E for G and that will still leave the informal seating area F untouched”, only for someone else to undermine everything you’ve said.

In the end if we’re going to invest properly in the Sandpit style of training, it is worth the effort to get things as right as possible, even if that involves some of us sinking, once again, into the period sofas, or forcing ourselves into yet another lunch in the conservatory. Get the venue right - then the creative juices will flow. The incisive ideas for responding to real problems out there in public health will come, and, everyone will be guaranteed a fun experience that truly beats your average university seminar room and is memorable for years to come!

Ahh… I think it’s time for afternoon tea. Earl Grey, Professor?

Speaking

Posted by Jean Adams

During most of my childhood, my dad worked for the Scottish Tourist Board. The main perk of doling out grants to tourist attractions was to be a guest of honour at said attractions. When I was about 14, he was asked to open a gliding centre on Deeside. It was during the school holidays, so I was allowed to tag along for the ride, so to speak. My one and only experience of gliding was absolutely, literally, and totally awesome. But before I got to go gliding, I had to listen politely, along with everyone else, to my dad speaking. He did so, in the middle of an air field, without notes, eloquently and succinctly.

My dad remains my public speaking role model.

Is it just me, or was he better at it last time around? (from: cbsnews.com)

Prior to beginning their dissertation project, all our MSc students have to give a presentation on their research plans to an audience of fellow students and course staff. This gives them a chance to get some feedback on their methods, to perhaps link up with the right supervisor, and to get some experience of presenting research is a reasonably unthreatening environment.

The first batch of this year’s presentations was last week. As usual, they were in a room that was just a little bit too small for the number of people in it. Everything felt a bit cramped. As usual, the confirmed staff attendance a few days before was abysmal, but we all stepped up at the last minute and there ended up being more staff than students in the room.

I didn’t do our MSc. Back in the day, perhaps before someone had worked out that it was fairly dumb to deliver the same course twice, intercalating medical students did a separate, but similar, course. But we still had to do the presentations, in the nerve-wracking environment of a lecture theatre. It was pretty scary. Despite what we’d been taught in our digital communications lessons, I’d never seen anyone successfully get a computer to speak to a digital projector. So I used overhead projector slides – perfect for a bit of added nerve-related fumbling.

I am now rarely nervous about presenting. Occasionally when the stakes are high – like the presentation you have to give at the start of a fellowship interview – I am still pretty petrified. But I think I would be in that sort of situation whether or not it involved a presentation. Sometimes I find the wait to ask a question in a seminar oddly nervy. I’m still waiting for the flood of invitations to be a conference keynote speaker. But I suspect that would also make me a bit uncomfortable.

Most people find that presenting gets less nerve wracking as they gain experience. The more you do it, the easier it gets. But standing up and speaking in front of a bunch of people who are there to judge your ideas is inherently scary. So it doesn’t quite make sense that it gets easier with practice. Perhaps all that diminishes is the nerves about forgetting what you’re going to say, or that there will be a computer meltdown. The more you do it, the more you convince yourself that you’ll be able to blag it, and that any audience would be sympathetic to things outside of your control.

Despite my apparent ease, I have still not developed my father’s skill for speaking without props. I have never not used Powerpoint, Prezi or some other visual aid. I always have notes. In most situations, I no longer practice ad nauseam, but I still do a quick run through. One day I hope to be brave enough to take the plunge and ditch the projector. One day I will stop presenting and just learn to speak.

The yes-no game

Posted by Jean Adams

I try hard to be a ‘yes’ person. Not a yes-(wo)man - I like to think I’m fairly critical and independent minded. But the sort of person who will be helpful and enthusiastic and say ‘yes’ when I can. I am, after all, pretty off the scale in conscientiousness and tend to think that yes is inherently a good thing.

This is in contrast to the ‘no’ people: the lazy, unhelpful people who can be relied upon only to say ‘no’. Or at least nothing much until you’ve given up hope and asked someone else.

The yes-no game

Public health is a collaborative science. It is probably still possible to while away a career in epidemiology without speaking to many people – especially if you have a big cohort study, or other data set, nestled up your sleeve. But once you get into the realm of developing and evaluating public health interventions, or even just collecting another round of data from your cohort study, you start to need big teams of people with varied expertise – a systematic reviewer, a statistician, a health economist, a qualitative researcher (goodness me I sometimes wish I was did one of those tangible things that people could give a name to). The effect is that there are all sorts of people asking you to say yes to taking part in this and that.

University research departments are also supposed to be pretty collaborative places – more than just the sum of their parts, but interactive groups of people getting stuff done together. There’s teaching, and supervision, and tutoring, and marking to be done; committees to contribute to; strategy to be developed and executed; a website to be maintained; a Christmas party to be organised. A whole lot more things that you are asked to say yes to.

At the same time, I have all of ‘my’ stuff to do: projects that are supposed to be finished sometime around when the funding expires; papers to write for my REF return, and those I just want to write; new grant applications to develop; ideas for blog posts to dream up.

Faced with so many requests to say yes, is pretty easy to develop a no mentality. In fact, not so long ago, my partner and I decided that the only way we were going to free our weekends from the tyranny of work was to get a lot more strict with our yes’s and a lot more liberal with our no’s. There was going to be a daily fess up about yes’s and communal pats on the back for each and every no. No was going to be the new black.

It didn’t take long before we worked out that this wasn’t going to work. Partly because it turned out we couldn’t remember all the yes’s and no’s we’d said by the end of the day, or even to remember to talk about them; but mostly because it turned out that each yes and no needed to be qualified.

There were the things we really wanted to say yes to, but couldn’t because of all the other previous yes’s. And the stuff that we wanted to say no to but said yes because of the possible fall-out of saying no to particular people. Fairly quickly we’d worked out a 2x2 table of: what you said x what you should’ve said if you only did the stuff you wanted to do.

We abandoned the scheme before it deteriorated into unknown knowns.

The problem is that I want everyone else to say yes to my things, but to be able to say no to just about everyone else’s. And so does everyone else.

My first blog post

Posted by Emma L Giles

Okay, so I’d better come clean and own up straight away…this is my very first blog. Now, it’s not like I didn’t know what a blog was before now, but I had never been that interested. I have a Facebook account and log on occasionally. I even tried twitter once, but I failed to ‘see the point’ of it. So when I thought I might venture into this blog business I wasn’t quite sure what the purpose was. However, since reading the Fuse blogs in particular, I think I may have seen the light.

The little book of anxiety, by Kerri Sackville

I am a post-doc, which basically means that since handing in my thesis (aka a large door stop that I have since looked at about ten times) in 2009, I have been working at Newcastle University as a Research Associate. My first post-docs were largely teaching-based, and so I would never have even contemplated writing a blog at that time. My topics would largely have been around such thoughts as: oh heck, what do I do when 300 students pile into the lecture theatre?? Oh my goodness, I was caught in the headlights today when I couldn’t answer a student’s questions, what to do, what to do??? I…honestly…cannot…mark…one…more…assignment…that…reads…the…same…

Gladly, such issues are no longer the reasons why I lie awake at night. Mainly because I have moved to the Institute of Health and Society at Newcastle and now I actually do research as a research associate, but also because after six years of teaching groups of 50-300 students I am no longer scared by large groups. I can think of a semi-professional and intelligent answer to most student questions, and I have learnt that every student contributes something different in their assignments (most of the time).

So why then am I writing this blog? Well, I was actually going to write about my experience of publishing academic papers as a new career researcher. However, this thought abruptly ended when I started to type. I realised that my first blog might actually be somewhat lacking: would it be entertaining? Would I need to be funny (I’m not naturally a comedian)? What happens if the editor rejects my blog? What DO I WRITE? 

I think, funnily enough, this blog has actually taught me something. It’s taught me that I’m a born worrier and that there will always be something that I am anxious about. However, this is where I can see some advantages of this blog business (I may even have started to like them as well). Blogs allow you to air your thoughts, to share concerns with others, and to (sometimes) receive helpful comments and advice.
I think I’m going to write that second blog soon, surprisingly about my worries around publishing. That is, if the editor doesn’t reject this first blog.

However, don’t ask me to go on twitter again.

Supervising

Posted by Jean Adams

If you think being an epidemiologist is a difficult job to explain, you should try being a lecturer with 85% dedicated to research. “Me? I'm a lecturer at the university....Well, no, I don’t actually do much lecturing....”

I think I only give two classic, big lecture theatre, lectures a year. I do a bit more classroom-based seminar teaching. But most of my teaching is one-to-one with students doing research projects.

The big (anatomy) lecture theatre at Leiden

I generally look after one or two undergraduate students doing final year projects each year, two or three masters students doing their dissertations, and I have four ongoing PhD students. We tend to supervise in teams, so I am not solely responsible for all of these people and two of the PhD students are due to submit in the next few months. Hopefully one will be replaced by someone else I am currently helping to work up a doctoral fellowship application.

Research projects were the part of being a student that I enjoyed the most, and I enjoy supervising research students. But despite the advice from students, and some mock bravado on my part, I don’t always find supervising students that easy.

The great thing about supervising is how different each journey is. Every project is different, with different challenges, and every student struggles with different things. For me this keeps the task interesting and engaging. But it also makes it difficult. Just like it is vaguely ludicrous to suggest that there could be a simple list of ‘rules’ for how to be a successful research student, so there is no simple rule book for how to be a supervisor.

I particularly struggle with how much direction and feedback I should give.

Student research projects are rewarding because they allow students to guide and own their work. Particularly at undergraduate level, they are one of the few parts of university learning that truly belong to the student. Having a supervisor that spends most of the time saying “do this”, “do that”, “definitely don’t do that” seems almost like robbing the student of this precious experience. But it is not uncommon to get a bit of a blank response when I ask what should, or even could, been done to solve a problem. Perhaps it is not a question that many students are used to hearing as an undergraduate. And when someone is nearing a deadline and feeling stressed enough already, sometimes “well, what do you think?” can push them right over the edge. It can be a tricky balance to get right.

Recently, however, I have been struggling with almost the opposite problem: how many times I should give the same feedback before becoming insistent that my suggestion is acted on.

Perhaps the problem is the very terminology of ‘suggestion’. I often tell my students that they don’t have to do what I say, that my comments are just ‘suggestions’. But clearly they aren't always. Every now and then a project will get stuck and, as far as I can see, there is only one way to unstick it: my way.

Sometimes it doesn't matter if the student and I dance around the issue for a month or two – there are other things to be getting on with, the deadline is still months, if not, years off. Other times, something has to be done right now. I don't like being insistent – it is just the sort of supervisor (person) I don't want to be. I don't want to lecture. But if the situation really is critical, then perhaps I am letting the student down by not insisting?

One of the common things that students do is to get personally and emotionally wrapped up in their work. I hesitate to call this a 'mistake'. I did it when I was a student. I do it now that I am not. I try not to be personally offended when my grant applications fail to get through to the short-list, or my papers are rejected without review, but I still am - a bit, sometimes. It can certainly mean you experience more of a blow than strictly necessary when things go wrong. But it probably also helps drive good quality. So maybe a 'risk', more than a 'mistake'.

What I hadn't quite realised was the risk of getting personally and emotionally wrapped up in my students. I have found that it matters to my personal sense of my professionalism that my students do well. The rare ones who do badly feel like failures. At least in the short term, until I have convinced myself that I did all I could: often including rather desperate lectures on standards expected and taking responsibility.

The pensiveness of the long distance runner*

Posted by Jean Adams

Have you been following #episongs? It’s like a game. But for epidemiologists. On Twitter. You’ll appreciate this lends it a certain in-crowd, geekiness:

     Bayesian Rhapsody (from @martinwhite33)

     One way or ANOVA (from @soozaphone)

     Geoffrey Rose the boat ashore (from @gingerly_onward)

     You say use StAYta, I say use StAHta (yours truly)

I have been using my running time this week to dream up contributions.

The loneliness of the long distance runner, Dir. Tony Richardson

I run most days. I down tools sometime between 5 and 6pm, gather up my stuff, head down to the toilets in the lobby of our building, where a secret door takes you through to a tiny changing room, and change from smart young professional into Supergirl. Well, more often it is from slightly scruffy climbing hut chic (as my dad once graciously labelled it) into rather smelly day-glo shirt and running tights.

Often I can’t quite be bothered. But I have found that this thought can be turned off long enough to get changed and out the door and by the time it comes back there’s no choice left.

I run because I like to be fit enough to keep up with my climbing hut buddies, because it gives me licence to eat a certain amount of cake, because it gets me outside for at least 45 minutes, and because it allows my brain to think in a different way from normal. I think it keeps me healthy. But it might not.

When I'm running, my thoughts take on a different quality. I don’t have to stop them because I need to focus on getting an abstract down to 250 words, wording an email just right, or so I can work out what exactly the person speaking is trying to say. I can just let them happen. But it’s not like there is a jumble of thoughts. Often it’s just one thing. Going back and forth. Round and round. Upside down.

I have some of my best ideas when I'm running. Ideas for research projects. Ideas for how to solve the problem I've been sweating over all day. Ideas for how to teach the cohort study session without killing everyone in the room with boredom. Ideas for #episongs.

Sometimes I think that the quality of my thoughts is so good when I'm running that running time should be reclassified as working time. Other times, my thoughts are not about work at all and I would feel resentful of having to think about something in particular when I'm running.

I presume the two things are not unlinked: my thoughts happening differently, and the good ideas coming. I presume there’s a technical term for the thoughts thing too. Once when my brother was particularly frustrated about something or other, I suggested he take up running. He said he was going to go on a meditation retreat instead. I suspect they might amount to nearly the same thing.

I'm a bit of a running evangelist  But I try not to be a running bore. Pounding the same loop, or variations of it, day after day is not that interesting of itself. Beyond the occasional wildlife spot, hardly anything interesting happens when I run, apart from in my head. There is not much about running itself to talk about. And, to be honest, I can get the same thought effect from swimming, walking and various other repetitive physical pursuits.

What I really want to get out of running right now is a running related #episong


*with apologies to Alan Sillitoe

This post would have been about bureaucracy, but it got caught up in red tape

Posted by Bronia Arnott

When your research is funded it is such a great feeling. You have spent hours toiling over your budget spreadsheet, having it rejected by the Institute finance officer, reclassifying your directly incurred and indirectly incurred costs. You have carefully crafted your theoretical argument and honed your methodological choices. You have even agreed to do another systematic review. And all that hard work has paid off; your research grant has been funded. Now that the money is finally in your hands you can do what you wanted. Right? You clearly haven’t worked in a University before, have you? 

If you had, you would have met the Director of the Institute of Red Tape: Mr Bureaucracy*. Mr Bureaucracy doesn’t care what your research project is, how much money you got, or who it was funded by; all that he cares about are rules and regulations. Before his promotion to Direction of Red Tape, he was Head of Health & Safety. The most impressive thing on his CV to date is his design of the Research Passport System.

I wouldn’t mind but I’m not asking to go out and buy a designer handbag with the money, I’m not asking to inflict torture on participants, I’m not even suggesting that my colleagues and I go on a round the world cruise; I’m asking to do what I said I would do and what I was funded to do. If I carefully researched the cost of an iPhone, made sure I put it into the right costings column on my grant application, and then the funding body agreed that we needed it so that we could develop a smartphone app to investigate mHealth then please, PLEASE, don’t tell me that a Nokia is just as good AND significantly cheaper.

Thankfully, all of the staff within my research institute who deal with finance and research governance are absolute stars and are not like Mr Bureaucracy at all. But if you do come across him please let me know; I need to speak to him about an iPhone.

*This character is entirely fictional, and any resemblance to any individual dead or alive is coincidental.

Working effectively with patients and public in research

Posted by Dorothy Newbury-Birch

I’m chair of the Engagement Strategy Group in my research institute. I’m not sure, like most things, how that came about, but I’m here and I’m on a steep learning curve. You see, like most of us, for a long time I thought that patient and public involvement meant that we should have a couple of lay people on our steering groups. And I was wrong, so wrong. It is so much more than that and if done properly can make your research much better in so many ways. I can only talk for myself but I’ve really started thinking about this differently, in particular, in relation to one of the trials I am the Principal Investigator (PI) for.

How not to do patient and public involvement in research

SIPS JR-HIGH is a pilot feasibility trial of alcohol screening and brief interventions in schools with 14-15 year olds. On the program management group we have a representative from the education department at the local council. He has expertise in alcohol and drug education in schools and we’ve met with him a number of times both at the project management group and separately to discuss the intricacies of the work. He’s a co-PI on the project and his input was invaluable to its success in being funded. He was also our link to getting the schools on board.

We have the Young Mayor (yes, North Tyneside has a Young Cabinet) on our Trial Steering Group, who we have met and spoken to a number of times. The Young Cabinet also looked over all our paperwork prior to submitting our application for university ethics approval. We also have a young person and their mum on the steering group. They were interested in the research, trialled our intervention and gave us valuable feedback. We've been to a couple of the schools a few times to trial the questionnaires and to ask them what they think of the information leaflets we’re using.

So what are my tips from my new found knowledge? Firstly, don’t just expect people to rock up to a meeting after sending them piles of paperwork and expect them to engage. Meet with them prior to the meeting; explain what is going to happen at the meeting. Talk through some of the issues and the paperwork and get their views. Explain to them that their input is important. Check to see if they need any help in coming to the meeting i.e car parking or childcare. Make sure you have spoken to them about financial reimbursement for their time. A great resource is available from INVOLVE which can help.

Secondly, have someone in the group meet with the person a few minutes before a meeting and have a coffee and introduce people as they turn up for the meeting. Have this person sit next to the lay member and explain things if necessary and encourage them to have their say if they want to. Don’t rush them away after the meeting; ask them what they thought and if they have any questions. Make arrangements to give them a call in a couple of weeks to chat through things if necessary. Work at their pace, don’t assume they can or can’t do things.

If you take these things on board, your research, I promise you, will be better and more fulfilling for yourself and the people we are doing the research with and for.

Turning the corner

Posted by Jean Adams

In university research there are two sorts of jobs: research jobs and academic jobs.

Research jobs are all about getting a particular research project done. Contracts are time-limited and you do research – collect data, analyse results, write reports. Academic jobs tend to be permanent and involve the classic triad of research, teaching and administration. The research bit is more about leadership than in research jobs – submitting grant applications, and supervising researchers employed on your projects. But there is also classroom teaching and student supervision. And let’s just not talk about the admin.

You can see why many people might aspire to an academic position - for the job security if nothing else.

Turning the academic corner

I wouldn’t be an academic if I didn’t now say “well, that’s actually a bit of an oversimplification, really – but it gives you an idea, doesn’t it?”.

Even before I finished my PhD I wanted an academic position. I wanted to ‘lead’. I wanted to teach. And after all those years as a full-time student (n=9), you betcha I wanted a nice, healthy pay-check every month forever.

I spent four years as a post-doctoral researcher before getting my first academic position. Less time than many, and for this I am very grateful. Now, a further four years on, it occurred to me recently that only now am I actually doing the job.

Although I knew all that stuff about the difference between research and academic jobs, when I first made the transition myself it seemed like nothing changed. Yes it was nice to stop getting those letters telling me that my contract was due to expire in three months. Yes it was nice to get a little bump in my salary with promises of more in due course. Yes it was nice to put “Lecturer in Public Health” in my email footer. But that was about it. My day-to-day job was pretty much the same. I analysed data, wrote papers, suggested ideas for projects to senior colleagues, shied away from any real responsibility.

And then I got scared. I wouldn’t be the “new lecturer” able to hang on the coat-tails of more senior colleagues forever.

And then I got more scared. I knew I had to get some grant funding, make sure my post-grad students flourished, and deliver good teaching. I tried to do all these things. But I didn’t seem very good at any of them. My grant applications were rejected. My post-grads seemed unable to tie down their research questions, let alone do some research. The big lecture theatre petrified me.

But, you know, it does seem true what they say. Once you’ve started, it gets easier; you just have to start. I got a little grant funded. Then I got another, bigger one. Then I got another. My post-grads are making their own, individual, journeys towards completion. I look forward to teaching seminars (although not preparing them) and whilst the big lecture theatre still scares me, I don't think it shows so much anymore.

So here I am just starting to think that I have finally turned the corner and might truly be doing the job I’m paid to do. And guess what? From August, they've promoted me.

How can I help you help me?

Posted by Dorothy Newbury-Birch

I’ve never failed to get practitioners on board for a research project.

I’m not bragging (oh okay I am a bit). Some of the projects have been really difficult environments to do research: Accident and Emergency Departments, prisons, probation, magistrates courts, crown courts, youth offending teams, police stations, schools, GP surgeries. But I see people struggling with engaging practitioners and I wonder why. It’s by no means easy – actually getting someone to answer the phone or respond to your email can be really difficult but there are ways around that. Don’t believe what people say about it being more difficult elsewhere in England either – we’re often told that its much harder in London to engage but I don't agree: it is harder to get around London for meetings, but not harder to engage. I’ve done it – I know!

So what are my tips for success in engaging practitioners?

1. Send an email followed up by a telephone call about a week later where you tell them you’re following up on your email will probably get you somewhere. If you are a Dr. or working with a Dr. saying this helps.

2. Use current contacts to help you – however remember if you say that ‘Dorothy’ suggested I call you that you are using my reputation, so use it wisely.

3. When arranging to meet, ask what suits them best. Making it clear that you will come to them,  out of hours if necessary, usually works.

4. NEVER say you want to arrange a meeting (even though you do). Always say something like, ‘have you got time for a coffee and a chat about some research I’m working on which I think you would be really interested in’.

5. When you do meet (for a coffee!) find out very quickly if they are the right person to talk to about the research – they may be the PI but it may be someone else that you will be liaising with. Get the first person to introduce you to the next person.

6. Don’t go the meeting (coffee) with a huge list of things you need them to do. Tell them about the research and go through the main things – the list should come later (although you should never have too long a list).

7. When you get to meet the team (there is usually a team) my years of research experience tell me that ONLY providing blueberry muffins works. For some reason, chocolate ones don’t work the same.

8. Offer solutions to problems. In one trial I worked on with probation where I wanted them to fax me something each day, they said that they didn’t have time. So I offered to set the fax up to send me the list at the same time that they HAD to send it to someone else.

9. Listen to their solutions. They know their systems much better than you.

10. Keep them updated with what is going on throughout the research. THIS IS REALLY IMPORTANT not just for your research project, but for others that may come after.

11. Ok, I know I have 11 tips and 10 sounds better but this one is important. Involve the people you’re working with in the design, carrying out and the dissemination of the work (if they want to) it really makes for much better research.

Nothing personal

Posted by Peter Tennant

When I was four feet tall, and each year felt like a Chinese dynasty, certain annual events used to really standout. The first hot day of summer. That strange day when there were flying ants everywhere. And the day when young adults would cry in the streets.

Apparently they had 'A-levels'. Or more accurately, they didn't.

These days, I find it harder to notice anything among the blur. Christmas is a long lunch. Summer a short weekend. But every now and again, grown men and women can still be found crying. The tears are usually less visible. But there’s no doubt about it, Fellowship applications are the A-levels of the early career researcher.

Vladimir Putin, after hearing he didn't get his fellowship

In a recent post, Fuse director Martin White listed personal funding (in particular getting a Fellowship) as one of 10 "easy" steps to achieve "rapid and effective progression" in a research career. It reminded me of one of those weird logic puzzles. If Andrea is lazier than Beth, and Catherine is greedier than Delia, how many cakes will Delia eat before Andrea has woken up? In short, getting a Fellowship may make career progression easier, but it's certainly not easy to get one. At least not in my experience.

At this point, my academic enemy would probably volunteer a simple explanation. Like the overly-blunt PE teacher to the short fat boy (sorry, boy of below average height and above average weight) who doesn't understand why he's so rubbish at the high-jump. But as much as we might blame my own academic physique, the statistics tell a bruising story. For every 5-10 applications, only one will be successful.

On the surface of it, this doesn't sound too bad. At least not in a world where there are hundreds of applications for any one academic position. But firing off a job application and applying for a Fellowship are like chalk and cheese. Occasionally cheese may have a chalky texture. But I guarantee, the chalk and pickle sandwich will never catch on.

To start with, Fellowship applications belong to that special category of things that completely take over your life. Partly because they take up so much time – I reckon I did about 200 hours on my NIHR Fellowship application, not to mention the countless time staring into space 'thinking' about it. And whenever I did stop thinking about it, a friend would usually ask: "Have you heard about your Fellowship yet?".

But it's the personal focus that makes a Fellowship application so uniquely challenging. Yes, the project needs to appear excellent. But so do you. And, sadly, not just in the eyes of your Mum (sorry Mum, but I'm afraid 'having good A-levels' isn't quite enough any more). Which means there's lots to write about how great you are and why you deserve the money more than anyone else. There's no place for modesty. So if I ever come across like a egotistical jerk, I'm just practising for my next application. Honest.

Before finishing, I would like to offer some advice. Some magic formula that boosts those slim chances of acceptance. But as a twice-reject, you might as well ask McDonald's to help solve the obesity epidemic. All I can advise, is you try to keep your emotional distance. They might call it personal funding, but (believe it or not) rejection is nothing personal.

Older and wiser? Musings from a ‘mature’ PhD student

Posted by Amy O'Donnell

Recent posts from Martin White and Dorothy Newbury-Birch have sent me musing (and no, before you ask, this isn’t yet another PhD distraction, I promise!).

On the one hand Martin’s first tip in his "From PhD to PI in ten easy steps" is to do your PhD young; on the other, Dorothy writes convincingly about how you might juggle 'mature' study with the domestic stuff that grown-ups tend to have to manage.

So where does this leave me I wondered? I've just turned forty, have two school age children, five pets (do they count?) and to throw into the mix, am currently facing a somewhat challenging time due to my partner's (lack of) employment situation.

Times are indeed tough. And believe me I often look at my younger, child-free peers rather enviously, imagining all the amazing progress I’d achieve if I didn't have after school activities to organise four nights out of five, weekends packed with football matches and Stagecoach, and general mortgage related-stress.

But when I seriously ask myself - “Should I have done this sooner? Could I have done this sooner?” - the answer to both questions is a resounding "No".

For starters, I think that the long and confused path I've taken to get this far has provided me with an invaluable skillset and bundles of what they call ‘life’ experience. I've worked in public affairs so I have a keen sense of the need to stay policy-relevant; I used to manage the BBC corporate diary (yes really) so bureaucracy and seniority doesn't faze me (mostly); and I spent most of my thirties at the rough end of the contract research wedge: bid-writing and mega-quick project turnarounds were my bread-and-butter.

Along the way, I think I've become a better and more seasoned writer and I've developed a deep-rooted passion for tackling social and economic inequalities. In particular, as a mother, I feel a sense of urgency to see things change for the better before my boys have to go out and face the big bad world. Personally, I really don't think I was ready before now. And I also think that with the current focus on translational research, those of us who have actually worked outside academia might have a valuable role to play in bridging the cultural divide.

Of course I understand this will undoubtedly limit my long term opportunities (unless I plan on working to 80…which is possibly not too ridiculous a prospect under the current government). Things haven't always gone quite to plan with the PhD either, so I haven't (yet) rattled off those all-essential publications. But, future academic employers, I do think I've still got lots to offer. Come January 2013, let's hope someone else does too.

What do you get if you mix a scientist and a mother?

Posted by Bronia Arnott

I came across a headline on the way to work a few weeks ago “The data confirms: If you want to stay in science and see your children grow up, don’t have children before you have tenure”. As a post-doctoral science researcher, who doesn’t yet have tenure, and is already a mother of one did I dare read on?

The headline was the title of a post on the LSE Impact Blog. It referred to the findings of a study which found that childless women are “paid, promoted and rewarded equivalently to their male peers” but mothers are “far more likely to move out of the research-professor pipeline…”.



So for those just starting out who want a career and kids, they just have to wait until they have tenure to have kids. Right? But what if you get tenure and then find out that you’ve missed your biological window of opportunity? I can’t imagine many people regretting not getting tenure on their deathbed, but I can imagine the years of heartache that come with not being able to have the children you wanted.

And I’m not convinced that once you have tenure you can sit back and relax. All the professors I know are always talking about how busy they are! REF papers and successful grant applications don’t write themselves.

So what about me? Should I just give up and go home?

I wasn’t convinced so I thought I would do what I do best and do some further research… I found a piece in the Guardian suggesting that the proportion of women in science is much lower in the UK low compared with the United States. The article suggested that the problem wasn’t getting women into science, but getting them to stay. Apparently they often drop out to start families. This was beginning to sound familiar.

I got my coat.

But wait…on my way out of the door I remembered I had attended my first full institute meeting of the Institute of Health and Society, at Newcastle University. There was the usual IT updates and grant successes, but then they started talking about the Institute being awarded the Athena SWAN Silver Award, and suddenly the meeting got a whole lot more interesting. Some of the staff even put down their knitting needles.

This award scheme recognises good employment practices for women working in science and related fields in higher education and research. The Silver award recognises efforts, above and beyond university-wide policies, to identify challenges faced by women and implement effective solutions.

Professor Judith Rankin, who led the application, said that the Institute “has always strived to introduce good working practices to ensure that those women who wish to combine a family with a career can”. Professor Eileen Kaner, Institute Director, said: "Success in achieving this award acknowledges the considerable work to make working in science an attractive career option for women."

Did you notice that? Two quotes from two women, both Professors, one the director of the Institute! In fact the Institute is full of examples of successful women, including those who have children, some who even had their children before they got tenure!

On my way to pick up my daughter later that day the whole issue was still playing on my mind. While I was boosted by the news that there was such great work going on in the UK to support women in science, I realised that is was a sad reflection of the existing inequalities. Surely we should be better at supporting men AND women in their careers AND in their family life?