Recommendations for International Gambling Harm-Minimisation Guidelines: Comparison with Effective Public Health Policy

Problem gambling represents a significant public health problem, however, research on effective gambling harm-minimisation measures lags behind other fields, including other addictive disorders. In recognition of the need for consistency between international jurisdictions and the importance of basing policy on empirical evidence, international conventions exist for policy on alcohol, tobacco, and illegal substances. This paper examines the evidence of best practice policies to provide recommendations for international guidelines for harm-minimisation policy for gambling, including specific consideration of the specific requirements for policies on Internet gambling. Evidence indicates that many of the public health policies implemented for addictive substances can be adapted to address gambling-related harms. Specifically, a minimum legal age of at least 18 for gambling participation, licensing of gambling venues and activities with responsible gambling and consumer protection strategies mandated, and brief interventions should be available for those at-risk for and experiencing gambling-related problems. However, there is mixed evidence on the effectiveness of limits on opening hours and gambling venue density and increased taxation to minimise harms. Given increases in trade globalisation and particularly the global nature of Internet gambling, it is recommended that jurisdictions take actions to harmonise gambling public health policies.     

‘Slipping through the Net’: The Impact of Incremental Development on the Built Environment of the Historic Coastal Town of Queenscliff in Victoria,Australia

Studies of the impact of development on the built environment often concentrate on areas of sudden change, where new constructions of a radically different scale, purpose or style are clearly seen to dramatically alter existing places. However, change is often more gradual. The cumulative effects of a large number of individual small changes are both extensive and often unrecognized until after they have taken effect, each individual development having ‘slipped through the net’ cast by planning authorities. The problem with this incremental process is that the result is often the erosion of the spatial and experiential qualities previously valued in that locality. As an example, this paper investigates four residential planning case studies in Queenscliff, a small historic coastal town in Victoria, Australia. Through analysis of their individual and cumulative impact on the neighbourhood character of this town, the paper explores the broader implications for the built environment of other Australian coastal towns and highlights the difficulties faced by all planners and residents trying to protect the character of their towns.     

Promoting sexual well-being in social work education and practice

This paper explores the importance of including sexual well-being within social work practice and education. Social workers often work with individuals for whom opportunities for sexual expression are limited and who face discriminatory attitudes. Sexual well-being is a global concern, and is particularly relevant considering international interest in the influence of notions of well-being on mental and physical health. Implementation of new social care policy in England, underpinned by the well-being principle, provides practitioners with the opportunity to explore what is meaningful to individual’s well-being through person-centred approaches to practice. There is currently little coverage of sexual well-being within social work education, this means students and practitioners lack the knowledge and skills to challenge barriers. Promotion of the concept of sexual citizenship, with its associated rights and responsibilities, enables social workers to engage in rights focused practice. Sexual well-being is a sensitive subject and the social and personal barriers practitioners may experience in addressing this topic are explored.     

Treatment policy estimands for recurrent event data using data collected after cessation of randomised treatment

In the past, many clinical trials have withdrawn subjects from the study when they prematurely stopped their randomised treatment and have therefore only collected ‘on‐treatment’ data. Thus, analyses addressing a treatment policy estimand have been restricted to imputing missing data under assumptions drawn from these data only. Many confirmatory trials are now continuing to collect data from subjects in a study even after they have prematurely discontinued study treatment as this event is irrelevant for the purposes of a treatment policy estimand. However, despite efforts to keep subjects in a trial, some will still choose to withdraw. Recent publications for sensitivity analyses of recurrent event data have focused on the reference‐based imputation methods commonly applied to continuous outcomes, where imputation for the missing data for one treatment arm is based on the observed outcomes in another arm. However, the existence of data from subjects who have prematurely discontinued treatment but remained in the study has now raised the opportunity to use this ‘off‐treatment’ data to impute the missing data for subjects who withdraw, potentially allowing more plausible assumptions for the missing post‐study‐withdrawal data than reference‐based approaches. In this paper, we introduce a new imputation method for recurrent event data in which the missing post‐study‐withdrawal event rate for a particular subject is assumed to reflect that observed from subjects during the off‐treatment period. The method is illustrated in a trial in chronic obstructive pulmonary disease (COPD) where the primary endpoint was the rate of exacerbations, analysed using a negative binomial model.     

“I was Excited by the Idea of a Project that Focuses on those Unasked Questions” Co‐Producing Disability Research with Disabled Young People

In this article, we detail the politics and practicalities of co‐produced disability research with disabled young people with life‐limiting and life‐threatening impairments. We centre an ESRC‐funded arts‐informed co‐produced research project that has brought together a Co‐Researcher Collective of disabled young people. Co‐production is an established approach; however, our co‐researchers have led us to develop inclusive research practices that engage with online social research methods in innovative ways. As we detail our experiences, we aim to encourage disability studies researchers and others to adopt virtual environments when researching with and for the lives of disabled people.     

Clients as Teachers: Reciprocal Influences in Therapy Relationships

The value of the continuing education industry for therapists is questioned, as is the usefulness of therapy books and journal articles, as a means of engaging therapists in life‐long learning. Instead, it is argued that our clients are our best teachers and that therapists learn most effectively from their clients. Drawing on research studies with prominent theoreticians and therapists, and on case studies from clinical work, a number of important themes are identified as ways in which therapists are influenced by their therapeutic encounters with their clients. The themes explored in this article include: (1) intimacy and high emotional arousal with clients as we witness profound change; (2) being challenged by clients; and (3) allowing for boundary ‘crossings’ in order to develop more flexible ways of working with clients. The implications for professional development are discussed.     

Working with Domestic Violence: Ethical Dilemmas in Five Theoretical Approaches

Therapists working with domestic violence are trained in many different theoretical models, each based on different values and assumptions. Each model raises different ethical dilemmas. In this paper, five theoretical approaches are evaluated in relation to the ethical principles of: respect for clients' autonomy; beneficence; non‐maleficence; and justice. The inverse relationship between respect for autonomy and beneficence and non‐maleficence is discussed. The hierarchical asymmetry involved in the therapeutic relationship is also explored.