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Many have argued that the development of evidence-based policing (EBP) depends on those in law enforcement agencies receiving appropriate training in research methodologies and data analysis. Despite this, there are few detailed accounts of such training and its delivery. This paper describes and evaluates the contribution of training workshops for police officers and staff in driving forward EBP. The workshops, developed based on a model used in healthcare, sought to provide attendees with the knowledge, skills, and confidence to engage with research evidence during their work, and sat within a wider plan for organisational change within one force in England. We outline the development and delivery of the workshops, which were undertaken using an action research approach, and assess their impact including subsequent changes to practice. Finally, we consider the role these workshops played within organisational change, and reflect on how EBP can be promoted within academic-police collaborations. [ABSTRACT FROM AUTHOR]

Background: Existing research highlights an increase in psychedelic microdosing, particularly for therapeutic purposes and as a means for self-enhancement. However, we know little about the different routes into and out of microdosing, particularly by those who do not consume other illicit substances, and of the processes involved in the development, maintenance, and cessation of practices., Methods: Drawing upon a trans-national interview-based study of 23 participants actively microdosing (n = 19), about to start (n = 3), or who were past users (n = 1), we develop a phased-based analysis of different user pathways., Results: We identify key phases as: 'Awareness/Discovery', where participants became aware of microdosing; 'Research/Reframing', where they researched access, techniques, and undertook 'stigma work' to reframe risks; 'Access/Supply' where they sought reliable and safe sources of psychedelics and cultivated attitudes/practices/substances for longer-term use; 'Experimentation/Differentiation' where participants altered dosing levels/schedules and, inter-relatedly, differentiated 'effects' and 'benefits'; 'Independence/Incorporation' where they stabilised practices into patterns 'right for them'; and 'Expansion/Advocacy' where microdosing was linked to greater inter- and intrapersonal 'expansiveness'., Conclusions: Pathways in and out of microdosing are multilinear and differentiated. Nonetheless, a dynamic processual approach helps highlight the overall structure of changes involved which, we find, can entail a shift towards greater temporal and relational 'expansiveness', greater independence, and more incorporated practices. These shifts necessitated considerable 'work' variously to negate stigma, maintain supply, determine dose, document shifts, and other kinds of material-symbolic 'investment'. We also show the significance of processual/phased-based models beyond psychedelics to better understand drug-use journeys and temporalities which confound conventional dependency-focused paradigms., Competing Interests: Declaration of competing interest None of the authors have any interests to declare., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

In this article, I propose a novel theoretical framework for conceptualizing pandemic stigma using the metaphor of 'mutation'. This metaphor highlights that stigma is not a static or fixed state but is enacted through processes of continuity and change. The following three orienting concepts are identified: (a) lineage (i.e. origin narratives and initial manifestations are created in relation to existing stigmas, stereotypes, and outgroups), (b) variation (i.e. stigma changes over time in response to new content and contexts), and (c) strength (i.e. stigma can be amplified or weakened through counter- or de-stigmatizing forces). I go on to use this metaphor to offer an analysis of the emergence of COVID-19 stigma. The lineage of COVID-19 stigma includes a long history of contagious disease, resonant with fears of contamination and death. Origin narratives have stigmatized Asian/Chinese groups as virus carriers, leading to socio-political manifestations of discrimination. Newer 'risky' groups have emerged in relation to old age, race and ethnicity, poverty, and weight, whose designation as 'vulnerable' simultaneously identifies them as victims in need of protection but also as a risk to the social body. Counter-stigmatizing trends are also visible. Public disclosure of having COVID-19 by high-status individuals such as the actor Tom Hanks has, in some instances, converted 'testing positive' into shared rather than shamed behaviour in the West. As discourses concerning risk, controllability, and blame unfold, so COVID-19 stigma will further mutate. In conclusion, the metaphor of mutation, and its three concepts of lineage, variation, and strength, offers a vocabulary through which to articulate emergent and ongoing stigma processes. Furthermore, the concept of stigma mutation identifies a clear role for social scientists and public health in terms of process engagement; to disrupt stigma, remaking it in less deadly forms or even to prevent its emergence altogether., (© The Author(s) 2021.)

Amid fears about the medicalisation of old age, the high prevalence of sleeping medication use in older cohorts is a significant public health concern. Long-term use is associated with a plethora of negative effects, such as cognitive impairment and risk of addiction. However, little is known about the lived experience of older adults using sleeping medication longer term. Episodic interviews lasting approximately 90 minutes were conducted with 15 independently living adults, aged 65-88 years, who were using sedative-hypnotic or tricyclic sleeping medication for more than 11 years on average. Thematic analysis shows that participants divided their rationale for use into two temporal periods: (1) to ensure physical ability in the daytime and (2) to ensure emotional stability at night. Long-term sleeping medication was thus characterised as a form of 'emotional self-management' of the negative emotions associated with later life, blotting out feelings of loss and loneliness by inducing sleep. Participants feared loss of access to their medication 'supply', employing strategies to ensure its continuity, while expressing shame about their dependence. However, identity management, in the form of explanations, minimisations and social comparisons, functioned to downplay their addiction. Through this, long-term sleeping medication users were able to elude the spoiled identities and multiple stigmas of both the 'out of control' addict and the unsuccessful older adult by asserting a positive identity; that of the 'new' older adult, actively medicating for success both day and night.

Background: Public health leadership in England has taken a distinctive international stance by identifying the potential public health benefit of e-cigarettes for smoking cessation. This includes the development of a ground-breaking set of national guidelines for developing e-cigarette friendly stop smoking services. However, little is known about the views of staff engaged within these services and whether or how such services are becoming e-cigarette friendly. This study aimed to investigate the uptake and usage of e-cigarette guidance, from the perspective of those enacting tobacco cessation interventions 'on the ground'., Methods: Qualitative semi-structured interviews were conducted with 25 cessation service staff, including advisors (n = 15), managers (n = 5) and commissioners (n = 5) from eight different services in the South-West of England, UK. A thematic analysis of the transcripts was conducted using NVivo software., Results: Although some stop smoking services labelled themselves e-cigarette friendly, there was no consensus over what this should entail. For some, this meant active engagement, such as working with local vape shops, and in the case of one service, offering e-cigarettes through a voucher scheme to disadvantaged groups. For others, an e-cigarette friendly service was conceptualized in a passive sense, as one which welcomed service users using e-cigarettes. Many services did not use the 'e-cigarette friendly' claim in their branding or promotional material. Several discursive themes underlay differing staff attitudes. Those more reluctant to engage framed this in terms of their 'duty of care', with concerns focusing on the addictiveness of nicotine, lack of medically licensed product and ongoing scientific controversy. Those motivated to engage drew on a discourse of social justice goals and 'doing things differently' in relation to lower socio-economic status smokers, those with mental health issues and other vulnerable groups. Strong public health leadership was also identified as a key factor in changing staff attitudes towards e-cigarettes., Conclusions: On-the-ground enactment of e-cigarette friendly services is varied as well as reflective of the wider policy and regulatory environment. Although the context of English stop smoking services is one of austerity and change, there are opportunities for active engagement with e-cigarettes to achieve overall cessation goals. For this to occur, training, policy consistency and sharing best practice are needed.

Background: In a culture of preloading and late-night licenses, alcohol-related violence remains a persistent problem for police and public health. Understood as a ritualized 'micro-social' interaction (Collins 2009a, 2009b), entry into bars and clubs is a particular flashpoint for violence between bouncers/door staff and customers., Methods: A police-led initiative to deter excessive drunkenness and preloading using hand-held breathalysers (the #RU2Drunk scheme) was investigated from the perspective of security and bar staff using the devices. Interviews (n = 18 + 12), a focus group with security staff (n = 22) and a focus group with a security company (n = 3) were conducted in two seaside towns in the South-West of England, UK. A qualitative thematic analysis was conducted., Findings: Door staff emphasised the normality of 'determined drunkenness' and associated violence in their working lives. Breathalyser use appeared to disrupt the 'ritual' of the violent encounter by reconfiguring it into an interaction between customer and technology. This depersonalized the judgement about who was 'too drunk' to enter the venue, with the more discretionary nature of who to breathalyse hidden from customers. Other door staff found it less useful and saw it as a challenge to their authority and expertise. At a managerial level there was concern about the transfer of responsibility for policing the night time economy (NTE)., Conclusion: There is potential to reconfigure the violent encounter for door staff using breathalyser devices. However, this is more likely to succeed where other structural limits (e.g. restrictions on late licenses) are in place, and as part of wider policy initiatives to reconfigure the alcohol-saturated NTE leisure scene., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: The aim of this study was to identify and differentiate socially shared accounts of e-cigarette use (vaping) using Q-methodology, combining factor analysis with qualitative comments., Methods: Seventy statements on e-cigarettes, drawn from media, academic and online discussions, were sorted by participants along a continuum of agreement/disagreement, commenting on strongly ranked items. Each participant thus created their own 'account' of their vaping. A by-person correlation matrix of the sorts was conducted, then factor analysed, to identify similar accounts (p<0.01). Fifty-five UK vapers participated by post, 55% male, mean age of 46, 84% only vaping/16% vaping and smoking, 95% vaping daily., Results: Three accounts of e-cigarettes were identified. The first two were associated with having quit smoking; the third with ongoing tobacco smoking and vaping. In Factor One, 'Vaping as Pleasure', vaping was characterized as enjoyable, with long-term use envisaged and a medical model of vaping rejected. Factor One participants also held a strong vaping identity and were politically motivated to maintain the rights of adults to vape. In Factor Two, 'Vaping as Medical Treatment', vaping was understood as a pragmatic choice about how to medicate one's smoking addiction, with the aim being to treat and ultimately reduce nicotine dependence. In Factor Three, 'Ambivalent E-Cigarette Use', participants reported fewer benefits and harboured more negative beliefs about e-cigarettes; they also strongly rejected a vaper identity, having no interest in online forums or being labelled a 'vaper' themselves., Conclusion: The UK e-cigarette users in this sample were not a homogeneous group; differing in their beliefs, motivations for use, identity and political interest. In particular they diverged on whether they accepted a medicalized account of vaping and identified as a vaper. Public health messages targeted to one group of e-cigarette users may not resonate with others., (Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.)

Some scholars contend that genetic medicine is transforming the experience of illness and the social category of the family - bringing future risks into the present, and potentially strengthening familial biological bonds in light of these shared genetic risks. However, research has shown that genetic information is interpreted and acted upon through a rich repertoire of adaptable social, cultural and familial factors which pre-exist and interact with biomedical knowledge. This paper reports research into families living with Neurofibromatosis Type 1 (NF1), a highly uncertain condition the manifestation of which can vary considerably also within the same family and, for this reason, has been defined as a 'condition without parameters'. These characteristics make NF1 a particularly informative condition for the examination of family dynamics around genetic information. The study and the methodology are based on the exploration of family networks and allow us to investigate the interrelation of individual and familial constructions of the uncertainty of NF1. This also allows both theoretical and policy claims to be made about the danger of reductionist thinking about the transformative potential of genetic technologies., (© 2016 Foundation for the Sociology of Health & Illness.)

Background and Aims: The rapid increase in use of electronic cigarettes (e-cigarettes) has created an international policy dilemma concerning how to use these products. This study assesses the types of beliefs that e-cigarette users in the United Kingdom may hold concerning regulation., Design: Qualitative thematic analysis of written answers to open-ended questions., Setting: United Kingdom, questionnaire conducted by post, 44% recruited from online forums and 56% non-online., Participants: Fifty-five UK vapers, 55% male, mean age 46 years, 84% sole users of e-cigarettes, 95% vaping daily., Measurements: Open-ended questions on regulatory and policy options., Findings: 'Protecting youth' was seen as a fundamental regulatory requirement which should be achieved through childproofing, age limits, no advertising aimed at children and health warnings about addictiveness of nicotine, but not the restriction of flavours. There was little support for regulating e-cigarettes as medicines or limiting the strength of nicotine liquids. In terms of public use, participants argued against a blanket ban on public vaping given perceptions of a lack of scientific evidence of harm. However, they supported the principle of autonomy, that individuals and organizations have the right to restrict vaping. Some participants suggested banning vaping in places such as schools, hospitals or around food, in line with current smoking norms. Vapers' regulatory positions were accompanied by political concerns about the use (and misuse) of scientific evidence., Conclusions: With regard to regulation of e-cigarettes, issues that are salient to UK vapers may include the need for youth protection, regulation as medicines, strength of e-liquids, bans on public vaping and concerns about the misuse of scientific evidence., (© 2016 Society for the Study of Addiction.)

Background: Oral squamous cell carcinoma (OSCC) is a global healthcare problem associated with poor clinical outcomes. Early detection is key to improving patient survival. OSCC may be preceded by clinically recognizable lesions, termed oral potentially malignant disorders (OPMD). As histologic assessment of OPMD does not accurately predict their clinical behavior, biomarkers are required to detect cases at risk of malignant transformation. Epidermal growth factor receptor gene copy number (EGFR GCN) is a validated biomarker in lung non-small cell carcinoma. We examined EGFR GCN in OPMD and OSCC to determine its potential as a biomarker in oral carcinogenesis., Methods: EGFR GCN was examined by in situ hybridization (ISH) in biopsies from 78 patients with OPMD and 92 patients with early-stage (stages I and II) OSCC. EGFR ISH signals were scored by two pathologists and a category assigned by consensus. The data were correlated with patient demographics and clinical outcomes., Results: OPMD with abnormal EGFR GCN were more likely to undergo malignant transformation than diploid cases. EGFR genomic gain was detected in a quarter of early-stage OSCC, but did not correlate with clinical outcomes., Conclusion: These data suggest that abnormal EGFR GCN has clinical utility as a biomarker for the detection of OPMD destined to undergo malignant transformation. Prospective studies are required to verify this finding. It remains to be determined if EGFR GCN could be used to select patients for EGFR-targeted therapies., Impact: Abnormal EGFR GCN is a potential biomarker for identifying OPMD that are at risk of malignant transformation. Cancer Epidemiol Biomarkers Prev; 25(6); 927-35. ©2016 AACR., (©2016 American Association for Cancer Research.)

Social science research on lifestyle-related diseases typically focuses on patients' understandings and beliefs and takes the clinical risk for granted. We interviewed 30 healthy UK patients at high risk of heart disease, recruited from a family history trial at 2 weeks and 6 months after a discussion with a clinician about their risk, lifestyle and medications. The participants took four different paths: (i) pharmaceutical (most common, risk reduction with cholesterol lowering statins), (ii) mixed (statins and behaviour change), (iii) behavioural (behaviour change, focus on wellbeing) and (iv) 'lost' (no prevention, difficult social/personal circumstances). Drawing on Berg we argue that coronary heart disease (CHD) risk assessment technologies are formal tools that generate, rather than represent, high risk in a way that patients often experience lifestyle change as futile, because it rarely reduces their cholesterol to targets defined by the tools. We suggest social scientists studying incipient or 'proto-diseases', such as CHD risk, should not only focus on understandings but also investigate the technologies (and the associated guidelines, policies, clinical practice and pharmaceutical industry operations) that generate incipient diseases and patients' experiences of them. However, technologies do not determine experience and we also discuss elements that direct patients down other than the pharmaceutical path., (© 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.)

Statistically, men make less use of health-care services than women. This has been interpreted as the result of the 'hegemonic' masculine code in which 'real' men are understood to be physically fit, uninterested in their health and self-reliant. However, less attention has been paid to understanding how hegemonic masculinity intersects with the wider western socio-cultural contexts of men's help-seeking, particularly the valorization of health as a form of social achievement. This article presents the results of interviews with 14 higher socio-economic status (SES) men to uncover their 'interpretive repertoires' in relation to health and illness, help-seeking and masculinity. Although many interviewees drew on the stereotype of the 'Neanderthal Man' who avoids the doctors to explain help-seeking by men 'in general', they constructed their own experiences of help-seeking in terms of being responsible, problem-solving and in control. It is argued that the framing of help-seeking in terms of 'taking action' chimes with an increasingly pro-active 'expert patient' approach within western health-care. This conceptual reconstruction of the dominant masculine code in relation to help-seeking, from 'Neanderthal Man' to 'Action Man', may lead to greater gender equality in terms of accessing health-care. However, it has the potential to exacerbate social inequalities between men from different SES groups.

Background/objectives: Non-invasive prenatal genetic diagnostic (NIPD) tests are being developed using cell-free fetal DNA in the maternal circulation. NIPD tests avoid or reduce the need for invasive diagnostic procedures for conditions like Down syndrome. Discussion of ethical and social implications of these techniques is increasing. We report findings from a study of public attitudes relevant to the introduction of NIPD. A key aim was to examine the range of attitudes relevant to NIPD within a diverse sample., Methods: Qualitative analysis of written free text 'first responses' to a written neutral description of NIPD as part of a Q-methodology study conducted with a purposive sample of the UK population (n = 71)., Results: The majority (63%) of respondents described their first response as positive. However, respondents displayed ambivalence, expressing positive views of individual/medical rationale for NIPD and unease concerning public health rationale and societal implications. Unease related to eugenic reasoning underlying existing prenatal testing, 'too much control' in reproduction, commercial provision, information and support requirements for expanded testing, and limiting the use of testing., Conclusions: These findings suggest that regulating and monitoring commercial provision of NIPD services, and monitoring introduction and clinical use, are a public preference., (Copyright © 2011 S. Karger AG, Basel.)

In contrast to the psychological literature on adolescent smoking, little research has investigated the social identities of adult smokers. This study aimed to identify shared 'smoking identities' amongst a sample of 64 British smokers from different socio-economic groups using Q-methodology. Participants were asked to sort 70 items concerning smoking and smokers according to their agreement/disagreement with them. The 64 Q-sorts were then subjected to a by-person factor analysis yielding six factors, with the first four interpretable factors being presented here. Each factor is understood to represent a distinct 'identity position'. The first two, the 'addicted' smoker, and the 'in control' smoker, oriented around a biomedical model of smoking as an addictive health risk. The final two, the 'no big deal' smoker and the 'proud' smoker reflected alternative understandings and values. The identity positions also differed in the extent to which smoking was considered a core part of self-identity. Unpacking the 'smoking identities' of current smokers offers the opportunity to devise targeted health promotion.

Current National Health Service policy advocates screening to identify individuals at 'high risk' of cardio-vascular disease (CHD) in primary care. This article utilizes the work of Radley to explore how 'high risk' of CHD patients make sense of their new risk status. Results are presented here from a nested qualitative study within a quantitative randomized trial of a CHD risk intervention in primary care. 'Discovery' interviews were conducted with 'high risk' participants (n = 38, mean age = 55) two weeks after intervention and thematically analysed. In response to perceived threat, many participants sought to both 'minimize' and 'normalize' their risk status. They also reported intentions to act, particularly concerning dietary change and exercise, although less so for smoking amongst the lower socio-economic status participants. Such perceptions and intentions were contextualized within the life-course of later middle-age, so that both being at risk, and being treated for risk, were normalized as part of growing older. Social position, such as gender and SES, was also implicated. CHD risk interventions should be context-sensitive to the life-course and social position of those who find themselves at 'high risk' of CHD in later middle-age.

Background: Coronary heart disease (CHD) is the leading cause of death in the developed world, and its prevention a core activity in current UK general practice. Currently, family history is not systematically integrated into cardiovascular risk assessment in the UK, Europe or the US. Further, primary health care professionals' lack the confidence to interpret family history information and there is a low level of recording of family history information in General Practice (GP) records. Primary prevention of CHD through lifestyle advice has sometimes yielded modest results although, for example, behavioural interventions targeted at "at risk" patients have produced encouraging findings. A family history approach, targeted at those requesting CHD assessment, could motivate lifestyle change. The project will assess the clinical value of incorporating systematic family history information into CHD risk assessment in primary care, from the perspective of the users of this service, the health care practitioners providing this service, and the National Health Service., Methods/design: The study will include three distinct phases: (1) cross-sectional survey to ascertain baseline information on current recording of family information; (2) through an exploratory matched-pair cluster randomised study, with nested qualitative semi-structured interview and focus group study, to assess the impact of systematic family history recording on participants' and primary care professionals' experience; (3) develop an economic model of the costs and benefits of incorporating family history into CHD risk assessment., Discussion: On completion of the project, users and primary care practitioners will be more informed of the value and utility of including family history in CHD risk assessment. Further, this approach will also act as a model of how familial risk information can be integrated within mainstream primary care preventive services for common chronic diseases., Trial Registration: Current Controlled Trials ISRCTN17943542.