An Exploration of Doping in Recreational Welsh Rugby An Ethical Analysis of Policy Responses

2021 ◽  
Author(s):  
◽  
Luke T.J. Cox
Keyword(s):  
Public Health ◽  
Harm Reduction ◽  
Policy Response ◽  
Structured Interviews ◽  
Policy And Practice ◽  
Policy Makers ◽  
Alternative Policy ◽  
Recreational Athletes ◽  
The Uk ◽  
Rugby Players

Doping is widely misperceived as a problem limited to elite athlete populations. Yet evidence for the occurrence of doping at recreational levels can be found from a variety of sources across a range of sports. Understanding this phenomenon is made problematic because of the difficulties in accessing these athletes. The ambiguity in motivations for doping at this level has led researchers and policy makers to consider whether the problem is more one of public health rather than simply performance-related cheating in sport. This thesis explores the motivations, knowledge, perceived harms, perceptions of anti-doping policy, and the drug use practices of recreational Welsh rugby players, where prevalence is disproportionately high in the UK. Semi structured interviews with recreational Welsh rugby players (n=13) and gym users (n=9) from the South and West Wales region were conducted. Four key themes emerged: (i) the use of doping substances for aesthetic reasons; (ii) a concern for body image that can trigger doping; (iii) a range of problematic risk-taking behaviours; and (iv) lack of concern for anti-doping policy and practice. Given the harms associated with doping, attention was paid to the problem of identifying whether the primary policy response should be driven by health or sport organisations. An alternative policy response within harm reduction is here considered, adapting a contentious framework from the ethics of self-harm. Three broad alternative policy proposals are critically presented in relation to doping in recreational sport: (1) to prevent it; (2) to allow it; and (3) to supervise it. Each model is rejected. Due to the seriousness of the harms associated with doping and the public health threat, it is argued that public health bodies must provide specialist harm reduction for recreational athletes and gym users within Wales, to better protect the health of recreational athletes and the general public.

scholarly journals Military Veterans and Welfare Reform: Bridging Two Policy Worlds through Qualitative Longitudinal Research

2021 ◽  
pp. 1-14
Author(s):  
Lisa Scullion ◽  
Katy Jones ◽  
Peter Dwyer ◽  
Celia Hynes ◽  
Philip Martin
Keyword(s):  
Welfare Reform ◽  
Longitudinal Research ◽  
Military Veterans ◽  
Armed Forces ◽  
Veterans Affairs ◽  
Civilian Life ◽  
Policy And Practice ◽  
Policy Makers ◽  
The Social ◽  
The Uk

There has been an increasing focus in the UK on the support provided to the Armed Forces community, with the publication of the Armed Forces Covenant (2011), the Strategy for our Veterans (2018) and the first ever Office for Veterans’ Affairs (2019). There is also an important body of research – including longitudinal research – focusing on transitions from military to civilian life, much of which is quantitative. At the same time, the UK has witnessed a period of unprecedented welfare reform. However, research focused on veterans’ interactions with the social security system has been largely absent. This article draws on the authors’ experiences of undertaking qualitative longitudinal research (QLR) to address this knowledge gap. We reflect on how QLR was essential in engaging policy makers enabling the research to bridge the two parallel policy worlds of veterans’ support and welfare reform, leading to significant policy and practice impact.

“There is still a perception that homelessness is a housing problem”: devolution, homelessness and health in the UK

2016 ◽  
Vol 19 (2) ◽  
pp. 33-44 ◽  
Author(s):  
Martin Whiteford ◽  
Glenn Simpson
Keyword(s):  
Qualitative Interviews ◽  
Homeless People ◽  
Small Sample ◽  
Issue Salience ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Policy And Practice ◽  
Content Type ◽  
The Uk ◽  
Comparative Policy

Purpose The purpose of this paper is to provide an exploratory account of the links between devolution, homelessness and health in the UK. Specifically, it focusses on the policy context and governance structures that shape the systems of healthcare for homeless people in London, Scotland, Wales and Northern Ireland. Design/methodology/approach Empirically the paper draws on semi-structured interviews with a small sample of policy and practice actors from the devolved territories. Qualitative interviews were supplemented by a comparative policy analysis of the homelessness and health agenda within the devolved regions. Theoretically, it takes inspiration from Chaney’s concept of the “issue salience of homelessness” and explores the comparative character of healthcare as pertains to homeless people across the devolved territories. Findings The paper provides clear evidence of areas of divergence and convergence in policy and practice between the devolved regions. These features are shown to be strongly mediated by the interplay of two factors: first, the scope and scale of national and local homelessness prevention strategies; and second, intra-national variation in public health responses to homelessness. Originality/value The paper offers considerable insight from a comparative policy perspective into the nature of healthcare provision for homeless people in the devolved regions.

scholarly journals The National Referral Database: An initial overview

2019 ◽  
Author(s):  
James Steele ◽  
Matthew Wade ◽  
Marie Polley ◽  
Robert J. Copeland ◽  
Stuart Stokes ◽  
...  
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Data Cleaning ◽  
Current Trend ◽  
Big Data Analytics ◽  
Policy And Practice ◽  
Local Data ◽  
Policy Makers ◽  
Exercise Medicine ◽  
Exercise Referral

Background: In 2014 The National Institute for Health and Care Excellence (NICE) called for development of a system to collate local data on exercise referral schemes (ERS) to inform future practice. This database would be used to facilitate continued evaluation of ERS. ‘Big data’ analytics is a current trend in healthcare with the potential to influence decision making. Indeed, the use of health databases can spur scientific investigation and generation of evidence regarding healthcare practice. NICEs recommendation has not yet been met by public health bodies. However, through collaboration between ukactive, ReferAll, a specialist in software solutions for exercise referral, and the National Centre for Sport and Exercise Medicine, data has been collated from multiple UK based ERS to generate one of the largest databases of its kind and move towards meeting NICEs recommendation. Method: This paper describes the formation of The National Referral Database, its structure including outcome measures, data cleaning processes, and in two accompanying manuscripts the first initial observational insights are presented from analysis of this data. Results: Collating data from 19 ERSs on 24,086 individuals, a database has been created containing pre and post referral data for metrics including; physical activity, blood pressure, BMI, resting heart rate, SWEMWBS scores, ESES scores, WHO5 scores and ERQoL scores. After data cleaning processes there were 14 ERSs remaining covering 23,782 participants with an average age of 51±15 years and 68% of whom were female. Further, the database contains demographic information, reason for referral, medical conditions, and information on the referrer. Conclusion: This database has now been created and the initial data is available for researchers to interrogate. The National Referral Database represents a potentially valuable resource for the wider research community, as well as policy makers and practitioners in this area, which will facilitate a better understanding of ERS and other physical activity related social prescribing pathways to help inform public health policy and practice. Longer term plans include establishment of the database as an open resource, continually updated with additional data and version controls, for researchers to access for further research and policy makers and practitioners to use to inform their policies/practices.

scholarly journals Social Inclusion, Participation and Citizenship in Contexts of Neoliberalism: Examples of Adult Education Policy and Practice with Young People in the UK, The Netherlands and Ireland

2021 ◽  
pp. 57-78
Author(s):  
Nathalie Huegler ◽  
Natasha Kersh
Keyword(s):  
Adult Education ◽  
Young People ◽  
The Netherlands ◽  
Social Inclusion ◽  
Structural Barriers ◽  
Policy And Practice ◽  
Policy Makers ◽  
Economic Perspectives ◽  
The Uk

AbstractThis chapter focuses on contexts where public discourses regarding the education of young adults have been dominated by socio-economic perspectives, with a focus on the role of employment-related learning, skills and chances and with active participation in the labour market as a key concern for policy makers. A focus on ‘employability’ alone has been linked to narrow conceptualisations of participation, inclusion and citizenship, arising in the context of discourse shifts through neoliberalism which emphasise workfare over welfare and responsibilities over rights. A key critique of such contexts is that the focus moves from addressing barriers to participation to framing social inclusion predominantly as related to expectations of ‘activation’ and sometimes, assimilation. Key target groups for discourses of activation include young people not in education, employment or training (‘NEET’), while in- and exclusion of migrant and ethnic minority young people are often framed within the complex and contradictory interplay between discourses of assimilation and experiences of discrimination. These developments influence the field of adult education aimed at young people vulnerable to social exclusion. An alternative discourse to ‘activation’ is the promotion of young people’s skills and capabilities that enables them to engage in forms of citizenship activism, challenging structural barriers that lead to exclusion. Our chapter considers selected examples from EduMAP research in the UK, the Netherlands and Ireland which indicate that as well as framing the participation of young people as discourses of ‘activation’, adult education can also enable and facilitate skills related to more activist forms of citizenship participation.

scholarly journals Fraud in overseas aid and the challenge of measurement

2015 ◽  
Vol 22 (2) ◽  
pp. 184-198 ◽  
Author(s):  
Mark Button ◽  
Chris Lewis ◽  
David Shepherd ◽  
Graham Brooks
Keyword(s):  
High Risk ◽  
International Development ◽  
Local Context ◽  
Structured Interviews ◽  
Policy Makers ◽  
Content Type ◽  
The Public ◽  
The Uk ◽  
Practical Implications

Purpose – The purpose of this paper is to explore the challenges of measuring fraud in overseas aid. Design/methodology/approach – The research is based on 21 semi-structured interviews with key persons working in the delivery of aid in both the public and voluntary sectors. It uses the UK Department for International Development as a case study to applying more accurate measures of fraud. Findings – This paper shows there are significant challenges to using fraud loss measurement to gauge fraud in overseas aid. However, it argues that, along with other types of measures, it could be used in areas of expenditure in overseas governments and charities to measure aid. Given the high risk of such aid to fraud, it argues helping to develop capacity to reduce aid, of which measuring the size of the problem is an important part; this could be considered as aid in its own right. Research limitations/implications – The researchers were not able to visit high-risk countries for fraud to examine in the local context views on the challenges of measuring fraud. Practical implications – The paper offers insights on the challenges to accurately measuring fraud in an overseas context, which will be useful to policy-makers in this context. Social implications – Given the importance of as much aid as possible reaching recipients, it offers an important contribution to helping to reduce losses in this important area. Originality/value – There has been very little consideration of how to measure fraud in the overseas aid context, with most effort aimed at corruption, which poses some of the same challenges, as well as some very different challenges.

scholarly journals Mobilising knowledge in public health: reflections on ten years of collaborative working in Fuse, the Centre for Translational Research in Public Health

2020 ◽  
Vol 16 (4) ◽  
pp. 673-685 ◽  
Author(s):  
Peter van der Graaf ◽  
Mandy Cheetham ◽  
Amelia Lake ◽  
Mark Welford ◽  
Rosemary Rushmer ◽  
...  
Keyword(s):  
Public Health ◽  
Collaborative Research ◽  
Knowledge Exchange ◽  
Policy And Practice ◽  
Directional Information ◽  
North East ◽  
The North ◽  
Excellent Research ◽  
The Uk ◽  
Research Centres

Background: Fuse was established in 2008 as one of five public health research centres of excellence in the UK funded by the UK Clinical Research Centres collaboration. The centre works across five universities in the North East of England. This is an innovative collaboration and enables the pooling of research expertise. A prime focus of the centre is not just the production of excellent research, but also its translation into usable evidence, a dual focus that remains uncommon.Aims/objectives: This practice paper outlines Fuse’s approach to knowledge exchange (KE) by reflecting on ten years of collaborative research between academics and policy and practice partners in the North East of England. We will describe the principles and assumption underlying our approach and outline a conceptual model of four steps in Fuse’s KE process to develop collaborative research and achieve meaningful impact on policy and practice.Key conclusions: Our model describes a fluid and dynamic approach to knowledge exchange broken down in four steps in the KE process that are concurrent, iterative and vary in intensity over time: awareness raising; knowledge sharing; making evidence fit for purpose; and supporting uptake and implementation of evidence. These steps support the relational context of KE. Relationship building and maintenance is essential for all stages of KE to develop trust and explore the meaning and usefulness of evidence in a multi-directional information flow that supports the co-creating and application of evidence.

scholarly journals “Data makes the story come to life.” Understanding the ethical and legal implications of Big Data research involving ethnic minority healthcare workers: a qualitative study

2021 ◽  
Author(s):  
Edward S. Dove ◽  
Ruby Reed-Berendt ◽  
Manish Pareek
Keyword(s):  
Public Health ◽  
Big Data ◽  
Ethnic Minority ◽  
Health Research ◽  
Healthcare Workers ◽  
Minority Groups ◽  
Significant Implication ◽  
Structured Interviews ◽  
Increased Risk ◽  
The Uk

The aim of UK-REACH (“The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers”) is to understand if, how, and why healthcare workers (HCWs) in the UK from ethnic minority groups are at increased risk of poor outcomes from COVID-19. In this article, we present findings from Work Package 3, the ethico-legal stream, which undertook qualitative research seeking to understand and address legal, ethical, and social acceptability issues around data protection, privacy, and information governance associated with the linkage of HCWs’ registration data and healthcare data. We interviewed 22 key opinion leaders in healthcare and health research from across the UK in two-to-one semi-structured interviews. Transcripts were manually coded using qualitative thematic analysis. Participants told us that a significant implication across all stages of Big Data research in public health are drivers of mistrust – of the research itself, research staff and funders, and broader concerns of mistrust within participant communities, particularly in the context of COVID-19 and those situated in more marginalised community settings. However, despite the challenges, participants also identified ways in which legally compliant and ethically informed approaches to research can be crafted to mitigate or overcome mistrust and establish confidence in Big Data public health research. Overall, our research indicates that a “Big Data Ethics by Design” approach can help assure 1) that meaningful engagement is taking place and that extant challenges are addressed, and 2) that any new challenges or hitherto unknown unknowns can be rapidly and properly considered to ensure potential (but material) harms are identified and minimised where necessary. Our findings indicate such an approach, in turn, will help drive better scientific breakthroughs that translate into medical innovations and effective public health interventions, which benefit the publics studied.

scholarly journals A critical exploration of professional perceptions of harm reduction policy and practice in Vietnam

2021 ◽  
Author(s):  
◽  
Tuan Dung Truong
Keyword(s):  
Drug Use ◽  
Harm Reduction ◽  
Quantitative Methods ◽  
Brain Diseases ◽  
People Who Use Drugs ◽  
Structured Interviews ◽  
Policy And Practice ◽  
Public Health Perspective ◽  
Qualitative And Quantitative Methods ◽  
Reduction Strategies

<p>Throughout the 1990s, Vietnam experienced a dramatic rise in the prevalence of HIV among people who use drugs. In response, Vietnam’s Ministry of Health implemented several legal and policy interventions in the name of harm reduction. However, perceptions about drug use, people who use drugs, addiction and the nature of official interventions are contested. For many Vietnamese officials, abstinence remains the dominant philosophy. Drug use is considered a ‘social evil’ in Vietnam and people who use drugs face draconian controls and incarceration in the name of treatment and crime prevention.  Against this background, this thesis explores how key stakeholders perceive harm reduction philosophy and how they apply it in policy and practice. Based on qualitative and quantitative methods, it presents findings from a survey with 250 respondents and 26 semi-structured interviews, all with professionals involved in responding to drug use in Vietnam. The thesis illustrates that these professionals prefer abstinence approaches, and often see addiction as the result of moral failings and brain diseases.  While some interventions in the name of harm reduction are accepted, they are firmly rooted within a narrow public health perspective. Professional misperceptions about the key principles and practices of ‘authentic’ harm reduction are widespread. Many professionals believe, for example, that harms can only be limited through reductions in the demand and supply of drugs, or that detaining people who use drugs in compulsory treatment centres is a form of harm reduction.  These rationales have resulted in continuing police crackdowns, and the use of ‘pseudo’ harm reduction strategies to control and punish people who use drugs. Meanwhile, there are limited official attempts to address problems experienced by people who use drugs, like social isolation, stigma, discrimination, human rights violations, or problems of community reintegration. In conclusion, while a harm reduction rhetoric is regularly employed in Vietnam, ‘pseudo’ harm reduction strategies are carried out.</p>

scholarly journals Localising Vaccination Services: Qualitative Insights on an Orthodox Jewish Collaboration with Public health during the UK coronavirus Vaccine Programme

2021 ◽  
Author(s):  
Ben Kasstan ◽  
Sandra Mounier-Jack ◽  
Louise Letley ◽  
Katherine M Gaskell ◽  
Chrissy H Roberts ◽  
...  
Keyword(s):  
Public Health ◽  
Health Services ◽  
Implementation Strategies ◽  
Childhood Vaccination ◽  
Orthodox Jewish ◽  
Public Health Services ◽  
Structured Interviews ◽  
Religious Minorities ◽  
Context Specific ◽  
The Uk

AbstractEthnic and religious minorities have been disproportionately affected by the SARS-CoV-2 pandemic and are less likely to accept coronavirus vaccinations. Orthodox (Haredi) Jewish neighbourhoods in England experienced high incidences of SARS-CoV-2 in 2020-21 and measles outbreaks (2018-19) due to suboptimal childhood vaccination coverage. The objective of our study was to explore how the coronavirus vaccination programme (CVP) was co-delivered between public health services and an Orthodox Jewish health organisation.Methods included 28 semi-structured interviews conducted virtually with public health professionals, community welfare and religious representatives, and household members. We examined CVP delivery from the perspectives of those involved in organising services and vaccine beneficiaries. Interview data was contextualised within debates of the CVP in Orthodox (Haredi) Jewish print and social media. Thematic analysis generated five considerations: i) Prior immunisation-related collaboration with public health services carved a role for Jewish health organisations to host and promote coronavirus vaccination sessions, distribute appointments, and administer vaccines ii) Public health services maintained responsibility for training, logistics, and maintaining vaccination records; iii) The localised approach to service delivery promoted vaccination in a minority with historically suboptimal levels of coverage; iv) Co-delivery promoted trust in the CVP, though a minority of participants maintained concerns around safety; v) Provision of CVP information and stakeholders’ response to situated (context-specific) challenges and concerns.Drawing on this example of CVP co-delivery, we propose that a localised approach to delivering immunisation programmes could address service provision gaps in ways that involve trusted community organisations. Localisation of vaccination services can include communication or implementation strategies, but both approaches involve consideration of investment, engagement and coordination, which are not cost-neutral. Localising vaccination services in collaboration with welfare groups raises opportunities for the on-going CVP and other immunisation programmes, and constitutes an opportunity for ethnic and religious minorities to collaborate in safeguarding community health.

Knowledge translation and health policy for burden of disease

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Pallari ◽  
S T Thomsen ◽  
H B M Hilderink
Keyword(s):  
Public Health ◽  
Knowledge Translation ◽  
Burden Of Disease ◽  
Policy And Practice ◽  
Regional Office ◽  
Policy Makers ◽  
The Public ◽  
European Public ◽  
Disability Adjusted Life ◽  
Life Years

Abstract A key goal of most Burden of Disease (BoD) studies is to support public health policies. However, while the concepts of BoD and Disability Adjusted Life years have been introduced more than 25 years, BoD researchers are still struggling to find better ways to translate their findings and communicate them to the relevant decision makers and other stakeholders. To address this gap, the burden-eu COST Action aims to generate better guidance of the use of BoD metrics in policy-making processes. In collaboration with experts in knowledge translation and risk communication, the Action will compile good practices in knowledge translation and develop a roadmap to integrate knowledge translation in national BOD studies. To support these objectives, collaborations have been established with knowledge translation experts from the European Observatory on Health Systems and Policies, the WHO Regional Office for Europe, and the European Public Health Association. During an initial meeting of the “knowledge translation” working group, 29 participants identified elements in the pathway from evidence generation to practice that need to be addressed. Building on the outcomes of this meeting and the inputs from the knowledge translation experts, this presentation will introduce the knowledge translation framework, and address some of the challenges in identifying best routes to reach out to the public and policy-makers. Specific emphasis will be placed in profiling the context, actors and processes of each country within the policy triangle, and drawing on best and worst example case studies. Additionally, the process will be discussed to co-create a toolkit or guide for using BoD evidence in policy and practice. The session will conclude with an interaction with the audience to learn about the perceived barriers for implementing knowledge translation within the BoD framework.

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