Preventing Coronary Heart Disease by Studying Potential Risk Groups

Hello! Who are you and what are you working on?

I am an academic at the University of Malta and a research student at the Faculty of Medicine and Surgery. Currently, I am working on the CRISO project “Coronary Risk Prevention in Siblings and Offspring of Patients with Premature Coronary Heart Disease.” The aim of this project is to develop a preventive program for a ‘neglected’ population group. The focus of this project is to identify significant resources that support risk factor modification in those at an increased risk.

(See the registered protocol at https://apps.who.int/trialsearch/Trial2.aspx?TrialID=ISRCTN21559170)

I started my studies in preventive cardiology at the Imperial College of London, where I could get a chance to learn from the experts in the field. This was a fantastic experience as I could develop professionally and personally while working on my research project, the Patient Adherence to Cardioprotective Interventions (PACI) project. This project focused on adherence to preventive cardiology guidelines in secondary prevention.

(See the freely accessible paper at   https://bjcardio.co.uk/2017/10/the-paci-survey-patient-adherence-to-cardioprotective-lifestyle-interventions-in-myocardial-infarction-patients-treated-with-primary-percutaneous-coronary-intervention/)

In the second part of my research, I collaborated with Huddersfield University and conducted a systematic review with a meta-analysis about preventive interventions in those patients that are at an increased risk. This helped me to grow and develop new skills so as to continue building on my research.

(See the freely accessible paper at   https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0241193)

What’s your backstory and how did you come up with the idea?

I did my B.Sc. in Nursing at the University of Malta. I spent around 8 years working in the clinical area of cardiology at Mater Dei Hospital. Then I pursued an M.Sc. in preventive cardiology at Imperial College. The nursing profession has always fascinated me, and it has taught me a lot about compassion, empathy, and the need to educate people on how to lead a healthy life. Working in the Critical Cardiac Care Unit and monitoring patients who suffered a heart attack made me realize that our work should start even before the patient arrives at the catheterization lab. This made me desire to look beyond the disease itself and learn more about primary prevention efforts. In my M.Sc. I studied both the primary and the secondary prevention methods of cardiovascular disease while focusing my M.Sc. research on secondary prevention. This experience made me pursue a similar field for my Ph.D. studies, but this time looking at primary prevention methods.

Please describe the process of learning, iterating, and creating the project

Well, it is a long process as it involves regular checks and a good sense of balance while iterating back and forth, which sometimes can get quite frustrating. I am happy to meet and support individuals who are seeking a cardiovascular risk assessment. From the impression that I am getting, they seem to be finding the program interesting. I hope it will be of benefit to their cardiovascular health. I will hopefully have an answer to that question at a later stage of my studies.

Please describe the process of launching the project

Luckily, my project has already received a lot of attention and support from stakeholders. The program being tested was discussed with our cardiology chairman at Mater Dei Hospital, and his expert advice was taken on board. I still don’t have a date for publishing my project, but this will be marketed for both clinicians and academics. Also, the doctoral committee at the faculty of Medicine and Surgery has already been given the necessary updates on my research project.

Since launch, what has worked to make your project grow/successful?

The project has not been launched yet, but I will be writing papers for publication throughout the project.

How is everything going nowadays, and what are your plans for the future?

With the COVID-19 pandemic, things haven’t been easy. Some study participants have been canceling clinic appointments out of fear of being exposed unnecessarily to the virus. This has slowed down the recruitment phase, and I might therefore need an extension for data collection. I am also working on other mini-projects, such as writing papers for publication and structuring my thesis chapters. This Ph.D. project is an excellent one, and I am optimistic that the recruitment will quickly pick up once the COVID-19 situation hopefully calms down in the next few months.

Moreover, I am sure that this project will be a fruitful one and will open other routes for future research. It is always a good idea to step up and continue building on what you have learned and worked on before.  I am currently working on a paper that I hope to publish in a high-impact peer-reviewed journal.

Through your science, have you learned anything particularly helpful or advantageous?

I surely did. The best lesson that I have learned is to own the project, believe in it, and carry on no matter what the obstacle is. If you’re going around in circles or seeing that you’re at a dead end, you can always look at the study from a different perspective. It takes time and much patience. The first step and I dare say the most important, is to formulate a detailed protocol at the early stages of the project. Getting it done correctly will increase your chances of remaining on the right track and getting the funds needed.

We’d like to know more about you, could you please let us know what is your morning routine like?

I usually wake up early, at around 6 am. I try not to miss breakfast, which typically includes fresh fruit. In the meantime, I check my emails and scroll the news online. I then head to the University campus, and I am at my office by 8 am. Mondays and Thursdays are clinic days where I usually start at around 7.30 am. By 9 am, I would need my first barista.

And how does a typical day look for you?

My days involve actively exchanging emails with colleagues, collaborators, and students. Students need a lot of support to get their projects finalized by the deadlines. I am coordinating three study units while participating in others, not only cardiology related. I am still exploring new teaching methods, a process that, in my opinion, should never end. The feedback I get from my students guides me on what teaching methods I should pursue and those I should eliminate. Lately, I had to switch most of my teaching classes remotely using Zoom, and now I am spending more time working from home. I end up having a late lunch and an even later dinner. I spend an hour or so going over my projects later at night as I find that I am more productive at this time of the day.

What does your workstation look like?

My workstation can get quite messy, especially when I’m working on different assignments. I carefully organize my weekly schedule on the weekend. It is the only way I can keep on track with my work program.

What platform/tools do you use for your professional life?

Lately, I have started using Twitter and LinkedIn. This helps me to follow other researchers who share my same interests. I am also on ResearchGate. This is a way to keep me connected with other researchers who have similar research interests.

To write, I use MS Word and Endnote as my reference manager. Using referencing software is something I always recommend as it saves you so much time and energy.

What secondary software and apps do you use daily?

I use Excel, PowerPoint, and Adobe Reader. For statistics, I use IBM SPSS. I use Zoom for teaching, while GoogleMeet is the program I use with colleagues or dissertation students. G-mail is what I use for my emails and Google Calendar to organize my weekly schedule

How do you stay up to date on News and resources?

Suppose it is any news, mostly by social media. If it is medical news, I receive monthly updates from the ESC Preventive Cardiology.

What have been the most influential podcasts, or other resources?

Mostly I watch ESC 360. There are several influential resources for cardiovascular research.

What tools do you use in your personal life? Cook? Self Care?

My typical week always revolves around work, but I do find time to exercise, especially during the weekend. A skipping rope workout is what I usually do as soon as I get home. I think it is an excellent exercise. I do enjoy eating out with family and friends.

Advice for other scientists who want to get started or are just starting out?

Perseverance is the key. Research projects have lots of ups and downs. Personal life will have its challenges, and you might meet up with people who will not share your same passion. But, if you have found the courage to sign yourself up for a research project, then you definitely want it to succeed, and you need to move on no matter what. You will inevitably come across people who will encourage you and push you forward, but you will also bump into disheartening people. When I started my project, this wasn’t my only work; I had too much going on, and I wasn’t very focused and productive. For those who haven’t yet embarked on a Ph.d, my advice is to focus on one task and do an extensive literature review about the topic in question. It is not a bad idea to have a backup plan just in case your research question cannot be studied. Just be patient and never give up. Great things take time.

Thank you very much for your time, Justin. Where can we go to learn more?

Twitter: @justinleemifsud

University profile: https://www.um.edu.mt/profile/justin-leemifsud

LinkedIn: https://www.linkedin.com/in/justin-lee-mifsud-046b81ab/

ResearchGate: https://www.researchgate.net/profile/Justin_Mifsud