Research Ethics: in clear sight

First paragraph: On a Friday night in March 2009, I joined more than 30 doctors gathered at the Gleneagles Hotel for predinner drinks. We were attending a weekend meeting at the invitation of the University of Dundee's Hypertension Research Centre and Medicines Monitoring Unit after "positive feedback" from a similar gathering in January. Both meetings aimed to provide practices with sufficient information about the Standard Care versus Celecoxib Outcome Trial (SCOT) to enable general practitioners to decide whether to participate

REALITIES in health disparities:Researching evidence-based alternatives in living, imaginative, traumatised, integrated, embodied systems

Introduction: Under the backdrop of pervasive health inequalities, public health professionals, researchers and non-academic partners in the United Kingdom are mobilising to understand how and in what ways community assets can address health disparities at scale in complex systems. While there is recognition that cultural, natural and community resources can improve health outcomes, these are unequally dispersed with lack of integration in communities and health and social care systems. Researching Evidence-based Alternatives in Living, Imaginative, Traumatised, Integrated, Embodied Systems (REALITIES) is a participatory action research Scottish consortium of 57 with established community asset hubs in five localities with strong relationships uniting conflicting ways of seeing the world. Our collective of lived and felt experience community members, community-embedded researchers, academics and non-academics draws upon a variety of practices, methods, datasets and philosophies to expand existing approaches to tackling health inequalities.Methods: We present conceptual and theoretical underpinnings for our co-produced systems-level model and empirical findings from testing REALITIES across three disadvantaged localities (November 2022, ongoing). After explaining the context that led to the development of the new scalable REALITIES model for integrated public systems to interface with ‘assets’, we detail philosophical pillars and guiding principles for our model and how we applied these mechanisms to explain how integrated partnership working can lead to improved health outcomes across multiple public systems.Results: We present a meta-analysis from co-producing and testing the model, showing how measuring change in complex public systems involves critical investigation of People, Process, Place, Price, Power and Purpose. Our critique reflects on power imbalances and inequities in Research-practice-Policy (RPP) partnerships and suggestions for how to nurture healthy ecosystems: overcoming barriers and enabling participation; reflecting on challenges of scaling up, testability and complexity of RPP partnerships; moving from siloed learning to transdisciplinary collaboration in practice; ensuring knowledge exchange has direct impact on communities and frontline practitioners; embedding relational ethics and safeguarding into daily practice.Discussion: We propose the REALITIES model to unite alternative, sometimes conflicting, ways of thinking about public systems and community assets by continuously reflecting on entanglements between different assumptions about knowledge, reality, evidence, and unnecessary binaries between creative methodologies and scientific method

A case of critical thinking: marketing strategies used to promote licensed drugs

First paragraph: The UK government has stressed the need to question and challenge the actions of drug companies and the effect they may have on patients. A report by the House of Commons (HoC) Health Select Committee on The Influence of the Pharmaceutical Industry noted that it was important ‘to examine critically the industry's impact on health to guard against excessive and damaging dependencies' (HoC 2005, p. 97). Given ‘profit-maximisation' is drug companies' main purpose while patients strive for the ‘optimisation of drugs' benefit-risk ratios' (Abraham 2008, p. 869), this called for a case of critical thinking

The Importance of Connection and Creativity for Access to Greenspace

It’s widely understood that greenspace is important to our health. But while “access to greenspace” is typically assessed in terms of physical access, new research from the University of Edinburgh in partnership with the REALITIES consortium shows that this understanding excludes the experiences of people living in deprived rural communities, who may have physical access to greenspace but not see any health benefits due to a disconnection from their local landscape. Our findings from this research suggest: • “Access to greenspace” should not solely be understood in terms of physical access; other barriers, such as connection to greenspace, should also be prioritised in work in this area • Community members living in deprived areas in rural Scotland are particularly likely to encounter barriers to access rooted in disconnection from their local landscapes, despite being surrounded by nature • Creative-green interventions offer a means to restore this connection and offer a route for disconnected communities to re-engage with and benefit from their immediate natural environment • There is a need for more interventions which integrate creativity and the arts into efforts to reconnect people with nature, though these should be focused on the changing needs and wants of specific communities rather than “rolled out” to scale • We need to prioritise developing the evidence-base on both connection to greenspace in rural areas of poverty and the potential for creative-green interventions to facilitate connection to greenspace • Evidence, in this context, takes on many forms, most notably: the process of making art and being creative; the artwork itself (regardless of what it looks like); feelings and senses experienced in the body when out in nature; and connections formed through the act of coming togethe

Tobacco Harm Reduction and Nicotine Containing Products: Research Priorities and Policy Directions

Developments in tobacco harm reduction (HR) and the proliferation of nicotine containing products (NCPs) have important implications for tobaco control (TC). This report sets out a research agenda which will help map and examine these implications

The marketing of e-cigarettes: a quick snapshot

First paragraph: The electronic cigarette (e-cigarette) was launched as a new consumer product in the UK eight years ago.ii Sales now exceed half a million per year and analysts predict the e-cigarette industry, which is worth £150 million in the UK,iii will continue to grow as usage among smokers has more than doubled in two years.iv At present, they are not classed as tobacco products or medicines in the UK and are therefore only regulated under Trading Standards legislation. The situation may change if the health regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), enforces tighter regulations - a decision on whether e-cigarettes require marketing authorisation to prove safety and efficacy is imminent

Britain's efforts to reduce smoking are becoming a cash cow for big tobacco

First paragraph: It all began so well. A decade ago a heartfelt concern about the addictiveness of nicotine, and the enormous difficulties this presented for would-be quitters, led to an unprecedented investment in intensive smoking cessation services. Beyond Smoking Kills proudly proclaimed year-on-year increases in funding for stop-smoking services and the establishment of centres throughout the country. Access this article on The Conversation website: https://theconversation.com/britains-efforts-to-reduce-smoking-are-becoming-a-cash-cow-for-big-tobacco-2533

Lobby Watch: The Social Issues Research Centre

First paragraph: The Social Issues Research Centre (SIRC) is an "independent, non-profit organisation" that says it carries out "balanced, calm and thoughtful" research on lifestyle issues such as drinking, diet, and pharmaceuticals (www.sirc.org). However, it may be perceived that the organisation acts more like a public relations agency for the corporations that fund its activities. These include Diageo, Flora, Coca-Cola, GlaxoSmithKline, and Roche, among others. Although SIRC does publish this partial list of funders, it is not immediately apparent which company has sponsored which study. And in some instances this information is not included in media reports