Health and illness research: value-free or value-laden?

2021 ◽  
pp. 95-126
Author(s):  
Priscilla Alderson
Keyword(s):  
Health Research ◽  
Moral Realism ◽  
Critical Realism ◽  
Realist Evaluation ◽  
Ethical Naturalism ◽  
Ethical Concerns ◽  
Research Paradigms ◽  
Health And Illness ◽  
Health Related

This chapter asks whether health research can and should be value-free. It questions whether facts can be separated from values, and then considers: health-related rights; dignity in healthcare; truth, trust and consent; values and ethics in health research. The chapter also looks at: what critical realism can add on important ethical concerns that are missing or under-examined in other paradigms; health research paradigms and ethics; ethical naturalism and moral realism; learning from other major theorists: advocacy on many levels and, finally, the chapter compares the approaches to values in realist evaluation and in critical realism. In the detailed example, Graham Scambler combines critical realism with Habermas’s theories.

Introduction

2021 ◽  
pp. 1-10
Author(s):  
Priscilla Alderson
Keyword(s):  
Health Research ◽  
Critical Realism ◽  
Health Policies ◽  
Naked Eye ◽  
Research Paradigms ◽  
Health And Illness

Health and illness affect every interrelated aspect of all our lives. Many causal influences on health are unseen by the naked eye (viruses) but can have immense global effects, which are very varied and partly unpredictable. Health is a process, daily affected by contexts, policies, behaviours and beliefs. Health policies are practical and ethical as well as scientific, and often fail. These views run through the book on how critical realism helps us to understand them more fully. Contradictions between mainstream health research paradigms confuse and undermine the research, and theories for more valid and convincing research are considered. The chapter includes sections on the readership and aims of the book and a summary of all the chapters.

Rethinking theories: the basis of practical research and problems with paradigms

2021 ◽  
pp. 11-40
Author(s):  
Priscilla Alderson
Keyword(s):  
Health Research ◽  
Critical Realism ◽  
Care Service ◽  
Realist Evaluation ◽  
Social Health ◽  
Community Based ◽  
Practical Research ◽  
Global Problems ◽  
Health And Illness

Chapter 1 reviews: social and biomedical influences through the centuries; positivist health research and then problems with it; interpretive research and some associated problems; differences between positivism and interpretivism; realist evaluation compared and contrasted with critical realism and discourse analysis. The detailed example is an evaluation of a community-based integrated care service. The chapter ends with questioning the present unhealthy state of social health research, which undermines the hope that sociology can be generally respected, convincing and useful in helping to resolve serious global problems of health and illness. This prepares for future chapters that show how critical realism draws on the strengths and overcomes the limitations of these paradigms by combining them into larger analysis.

Structure and agency: making connections

2021 ◽  
pp. 65-94
Author(s):  
Priscilla Alderson
Keyword(s):  
Mental Health ◽  
Traumatic Brain Injury ◽  
Mental Health Problems ◽  
Critical Realism ◽  
Realist Evaluation ◽  
Social Structures ◽  
Injury Rehabilitation ◽  
Structure And Agency ◽  
Critical Realist ◽  
Health And Illness

This chapter continues to summarise different theories and methods in mainstream health and illness research in order to compare them to critical realism and show what it might add. Positivist, interpretive and postmodern approaches to human agency within structures are considered. There are also sections on: six features of critical realism; structure, agency and culture; four types of social structures; a comparison of realist evaluation and critical realism theories of structure and agency; the structure-agency dialectic, and Archer’s theory of internal conversations. The detailed examples of applying critical realist concepts are of prison leavers with mental health problems, and nurses working on traumatic brain injury rehabilitation. Throughout, the chapter critically considers problems posed for health researchers, to see how critical realist research theories of structure and agency can serve their work.

International Health Research Ethics

2020 ◽  
Author(s):  
Bridget Pratt
Keyword(s):  
Research Ethics ◽  
Health Research ◽  
International Research ◽  
International Health ◽  
Middle Income Country ◽  
Income Country ◽  
Benefit Sharing ◽  
Middle Income ◽  
Ethical Concerns ◽  
Low And Middle Income

Health research funded by organizations from HICs and conducted in low- and middle-income countries has grown significantly since 1990. Power imbalances and inequities frequently (but not always) exist at each stage of the international research process. Unsurprisingly then, a variety of ethical concerns commonly arise in the context of international health research, such as inequities in funding, the semi-colonial nature of international research models, the brain drain of low- and middle-income country researchers, and inequities in partnerships between HIC and low- and middle-income country researchers. In this chapter, these (and other) ethical concerns are introduced and the following ethical concepts to address the concerns are then discussed: responsiveness, standard of care, benefit sharing, community engagement, and social value. Existing guidance and remaining debates about how to specify each of the concepts are summarized. The chapter concludes by highlighting the existence of epistemic injustices within the field of international research ethics.

Health research capacity in Nepal: Analysis of the trend and the role of local researchers

2021 ◽  
pp. 004947552098277
Author(s):  
Madhu Kharel ◽  
Alpha Pokharel ◽  
Krishna P Sapkota ◽  
Prasant V Shahi ◽  
Pratisha Shakya ◽  
...  
Keyword(s):  
Health Research ◽  
Fold Increase ◽  
Research Capacity ◽  
Rapid Review ◽  
Evidence Based ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health Related ◽  
Evidence Based Decision Making

Evidence-based decision-making is less common in low- and middle-income countries where the research capacity remains low. Nepal, a lower-middle-income country in Asia, is not an exception. We conducted a rapid review to identify the trend of health research in Nepal and found more than seven-fold increase in the number of published health-related articles between 2000 and 2018. The proportion of articles with Nepalese researchers as the first authors has also risen over the years, though they are still only in two-thirds of the articles in 2018.

Holiness and Ethics

2018 ◽  
pp. 89-153
Author(s):  
Alan L. Mittleman
Keyword(s):  
Natural History ◽  
Moral Realism ◽  
Human Condition ◽  
Ethical Naturalism ◽  
History Of ◽  
The Right ◽  
The Human Condition

This chapter explores the connection between holiness and ethics or between holiness and goodness. Drawing on a theory of holiness in Judaism, it considers how holiness relates to other values, including moral ones, and whether holiness is more primordial or primitive than ethics. The discussion is anchored on two texts: the first from the Book of Leviticus, and the second from the modern Jewish thinker, Abraham Joshua Heschel. The chapter argues that holiness and morality are equally primordial, equally original to the human condition, and goes on to propose a natural history of holiness in which the human experiences of love and awe, of goodness and holiness arise together against man's evolutionary background as a social primate. It also examines the concepts of primordial morality, natural morality, ethical naturalism, and moral realism before concluding with an analysis of intuition in relation to the good, the right, and the holy.

scholarly journals Role of the Built and Online Social Environments on Expression of Dining on Instagram

2020 ◽  
Vol 17 (3) ◽  
pp. 735 ◽  
Author(s):  
Vishwali Mhasawade ◽  
Anas Elghafari ◽  
Dustin T. Duncan ◽  
Rumi Chunara
Keyword(s):  
Public Health ◽  
Built Environment ◽  
Online Social Networks ◽  
Health Research ◽  
Public Health Research ◽  
Time Of Day ◽  
Social Environments ◽  
Health Related Behaviors ◽  
Health Related

Online social communities are becoming windows for learning more about the health of populations, through information about our health-related behaviors and outcomes from daily life. At the same time, just as public health data and theory has shown that aspects of the built environment can affect our health-related behaviors and outcomes, it is also possible that online social environments (e.g., posts and other attributes of our online social networks) can also shape facets of our life. Given the important role of the online environment in public health research and implications, factors which contribute to the generation of such data must be well understood. Here we study the role of the built and online social environments in the expression of dining on Instagram in Abu Dhabi; a ubiquitous social media platform, city with a vibrant dining culture, and a topic (food posts) which has been studied in relation to public health outcomes. Our study uses available data on user Instagram profiles and their Instagram networks, as well as the local food environment measured through the dining types (e.g., casual dining restaurants, food court restaurants, lounges etc.) by neighborhood. We find evidence that factors of the online social environment (profiles that post about dining versus profiles that do not post about dining) have different influences on the relationship between a user’s built environment and the social dining expression, with effects also varying by dining types in the environment and time of day. We examine the mechanism of the relationships via moderation and mediation analyses. Overall, this study provides evidence that the interplay of online and built environments depend on attributes of said environments and can also vary by time of day. We discuss implications of this synergy for precisely-targeting public health interventions, as well as on using online data for public health research.

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