Grading gems: Appraising the quality of research about social work and social care.

The impetus towards basing practice and policy decisions more explicitly on sound research requires tools to facilitate the systematic appraisal of the quality of research encompassing a diverse range of methods and designs. Five exemplar tools were developed and assessed in terms of their usefulness in selecting studies for inclusion in a systematic review. The widely used ‘hierarchy of evidence’ was adapted and used to appraise internal validity. Four tools were then developed to appraise the external validity dimensions of generalizability (two scales) and methods of data collection (two scales). Methods of combining the scores generated by each tool were explored. Qualitative and quantitative studies were appraised, not separated into two spheres but by using complementary tools developed to appraise different aspects of rigour. There was a high level of agreement between researchers in applying the tools to twenty-two studies on decision making by professionals about the longterm care of older people. The scales for internal validity and generalizability discriminated between the qualities of studies appropriately. The two tools to appraise data collection gave diverse results. Excluding studies that scored in the lowest category on any scale appeared to be the scoring system that was most justifiable. This approach is presented to stimulate debate about the practical application of the evidence-based initiative to social work and social care. This study may assist in developing clearer definitions and common language about appraising rigour that should further the process of selecting robust research for synthesis to inform practice and policy decisions.

Reflexive Modernisation and Social Work in Ireland: A Response to Powell

The aim of this article is respond to some of the issues addressed by Powell (1998). It focuses on his consideration of the role and task of social work within a changing society. I argue that, before postulations about the future role of social work in Ireland can be made, consideration of its current nature and the form of its discourses are necessary. I then go on to critique Powell's analysis of social work in the context of concepts such as empowerment, participation and prevention and argue that, by failing to consider the necessarily regulatory and centralized nature of much of Irish social work currently, such an analysis remains merely rhetorical. Powell's reference to the Irish Association of Social Workers' Code of Ethics (1995) as evidence of social work entering a period of reflexive modernity is also examined. The article concludes with a call for a move away from utopian speculation within Irish social work discourse towards a more realistic and constructive analysis of both the future potential and the limitations of Irish social work, given its spatial and discursive constraints.

Obesity in People with Learning Disabilities: the impact of nurse led health screenings and health promotion activities

Background. Obesity appears to be more common among people with intellectual disabilities, with few studies focusing on achieving weight reduction. Aim. Firstly, to follow up people identified as overweight and obese following special health screening clinics and to determine the actions taken. Secondly, to evaluate the impact of health promotion classes on participants' weight loss. Methods. A clinic led by two learning disbaility nurses was held for all people aged 10 years and over (n=464) who attended special services within the area of one Health and Social Services Trust in Northern Ireland. In a second study, the nurses organised health promotion classes for 20 people over a 6 - 8 week period. Findings. The health screen identified 64% of adults and 26% of 10 - 19 year olds as being overweight or obese. Moreover, those aged 40 - 49 years who were obese had significantly higher levels of blood pressure. However, information obtained from a follow up questionnaire sent after 3 months suggested that of the 122 people identified for wiehgt reduciton, action had been taken for only 34% of them and only three were reported to have lost weight. The health promotion classes, however, led to a significant reduction in weight and body mass index scores. Conclusion. Health screening per se has limited impact on reducing obesity levels in this client group. Rather, health personnel such as general practitioners, nurses and health promotion staff need to work in partnership with service staff, carers and people with intellectual disabiltieis to create more active lifestyles.

Predictable Pathways? Negotiating Risk in the Context of Marginalisation and Social Exclusion

This article is based on ethnographic research with young people living in an area of multiple deprivation in the North-east of England. The young people in this study experience many risk factors associated with social exclusion and future offending. Through in-depth examination of crime within the context of their lives, it will be argued that recent theorisations of youth crime and criminal careers do not fully capture the nature of their offending, the contextual circumstances surrounding it and the differential impact of similar risk factors on their lives. The article concludes by suggesting that not only do such theories detract from the situations of poverty and social exclusion in which young people live but that youth policies informed by them potentially add to their experiences of exclusion and marginalisation.

The `Chicken and Egg' of Subjective and Social Factors in Desistance from Crime

It is now widely acknowledged that progression from persistent offending to desistance from crime is the outcome of a complex interaction between subjective/ agency factors and social/environmental factors. A methodological challenge for desistance researchers is to unravel the differential impacts of these internal and external factors and the sequence in which they come into play. Towards this, the present investigation draws on a prospective study of 130 male property offenders, interviewed in the 1990s (the Oxford Recidivism Study), and followed up 10 years later. The analysis supports a `subjective—social model' in which subjective states measured before release have a direct effect on recidivism as well as indirect effects through their impact on social circumstances experienced after release from prison.