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Please pass on to any students who might be interested... * * * * * * * Applications are invited from graduates with good honours or Masters degrees in relevant disciplines for PhD studentships tenable from October 2000. Research areas include: quantitative and qualitative health services research; aetiological, lifecourse, clinical and nutritional epidemiology; effectiveness and acceptability of health services/care; health/illness/disability in older age. Projects in statistics/economics/sociology/psychology applied to medical/clinical issues also encouraged. At least two full-time scholarships are available including one from the MRC. For further details of potential topics and supervisors, and application forms, see below or contact: Mrs Julia Mackay/Dr Jenny Donovan, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR (0117 928 7337). Email [log in to unmask] Web page http://www.epi.bris.ac.uk Closing date for applications 30th April 2000. Please note that only residents of the EU are eligible for studentships. * * * * * * * Candidates are encouraged to apply to study a topic of their own choice in an area related to the Department's core interests (see above and http://www.epi.bris.ac.uk), or apply for one of the following topics with the named adviser(s). You are encouraged to discuss your ideas with potential adviser(s). 1. Prof Shah Ebrahim: Locomotor disability: assessment, need and service responses This PhD scholarship is part of a programme of work concerned with the assessment, prevention and treatment of locomotor disability - a problem with walking or balance - among older people. Locomotor disability - defined as inability to walk, climb stairs or maintain balance - increases almost exponentially with age and self-reported locomotor disability affects over 3 million people aged 60 years and over (about a third of the total) in Britain. Professor Ann Bowling, (UCL), Professor John Bond (Newcastle) and Dr Christina Victor (St George's Hospital Medical School) are collaborating with Professor Shah Ebrahim to commision an Office of National Statistics omnibus survey of older people. This cross-sectional survey of 2000 people will collect data on quality of life, social support by informal carers, mood, isolation, locomotor disability, activity and participation in every day life, use of services, aids and applicances. A sub-sample of the participants will be followed up and interviewed in depth and all participants will be asked to take part in further follow up by postal questionnaire. We seek to answer the following questions: How appropriate and valid (from the perspective of older people) are existing "standard issue" (as used in censuses) brief disability questions? Does depressed mood affect responses to disability questions? How do quality of life assessments and disability measures compare? How do social and economic factors effect levels of disability experienced by older people? Why do older people reject support from health and social services? The data obtained from the ONS survey will be used to compare quality of life and disability measures, and associations between a wide range of social and demographic factors and disability to be measured. Modification of responses to questions about disability by depressed mood will be examined. Comparisons between responses to the "standard issue" questions on disability and more detailed locomotor disability assessment will be examined. Relationships between apparent level of need, as assessed by level of disability, and use of services, aids and appliances will be studied. Reasons for acceptance and rejection of such services will be explored with participants. 2. Dr Jonathan Sterne/Prof George Davey Smith: Causal Modelling for Life Course Epidemiology Standard statistical methods used in modelling epidemiological associations have limitations when used to assess the long-term effect of exposures measured on a number of occasions. Measurement error leads to underestimation of the size of associations, and proposed methods for correcting for such regression dilution bias depend on assumptions which may not be justified. The correlation between repeat measures means that assessing the relative importance of different exposure periods may be difficult, for example because of collinearity. The interplay between different exposures and outcomes over time may be complex; leading to "time-dependent confounding"; when the value of an exposure predicts the subsequent value of another exposure, and both are associated with the outcome. The purpose of this project is to use recently developed statistical approaches to improve on the methods currently used in life course epidemiology. The project will use a rich data set arising from the Caerphilly cohort, a cohort of originally middle aged men followed up in South Wales every 5 years for 20 years. The study was originally set up to examine the epidemiology of coronary heart disease but its scope has been broadened to include a wider range of health outcomes. Statistical approaches to be evaluated include the use of structural equation models and graphical models fitted using Bayesian methods. These can explicitly incorporate measurement error and correlations between exposures over time. "Causal" models, introduced by Robins, will be used to control time-varying confounding. 3. Dr Joanna Coast: The impact and cost of antimicrobial resistance Antimicrobial resistance is an important social externality that has not been captured at the level of economic appraisal. Although this is unsurprising given the difficulties associated with identifying and then costing the, often diffuse, impacts of resistance, it means that little information is available about the nature or extent of these costs. Such information is of prime importance for assessing the relative value of alternative interventions intended to prevent and control the extent of resistance. This project will focus on developing methods for measuring the impact, and costs, associated with resistance to antimicrobials. The student will need to review literature on the theory and conduct of economic evaluation, and the measurement and valuation of external effects, both positive and negative. They will also need to develop a full understanding of the nature of antimicrobial resistance in order to identify where the effects of resistance are most likely to impact. From this knowledge, methods for examining in detail the costs associated with resistance will be developed, incorporating both the identification of relevant impacts and the development of research tools to measure these impacts. Empirical case studies will be used to test and refine these methods. This multi-disciplinary research will give the student a detailed understanding of antimicrobial resistance and the economics of externality, but at a broader level the student will also develop a critical understanding of epidemiological and economic research design and will gain experience in reviewing economic and epidemiological publications. For an information pack about research studentships and contact details for advisers, apply to Mrs Julia Mackay, Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR (0117 928 7337), [log in to unmask] Deadline for applications: 30th April 2000. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%