Validation of model-based estimates (synthetic estimates) of the prevalence of risk factors for coronary heart disease for wards in England

Several sets of model-based estimates (synthetic estimates) of the prevalence of risk factors for coronary heart disease for small areas in England have been developed. These have been used in policy documents to indicate which areas are in need of intervention. In general, these models have not been subjected to validity assessment. This paper describes a validity assessment of 16 sets of synthetic estimates, by comparison of the models with national, regional and local survey-based estimates, and local mortality rate estimates. Model-based estimates of the prevalence of smoking, low fruit and vegetable consumption, obesity, hypertension and raised cholesterol are found to be valid.

The implementation of chlamydia screening : a cross-sectional study in the South East of England

Background England's National Chlamydia Screening Programme (NCSP) provides opportunistic testing for under 25 year-olds in healthcare and non-healthcare settings. The authors aimed to explore relationships between coverage and positivity in relation to demographic characteristics or setting, in order to inform efficient and sustainable implementation of the NCSP.

Methods The authors analysed mapped NCSP testing data from the South East region of England between April 2006 and March 2007 inclusive to population characteristics. Coverage was estimated by sex, demographic characteristics and service characteristics, and variation in positivity by setting and population group.

Results Coverage in females was lower in the least deprived areas compared with the most deprived areas (OR 0.48; 95% CI 0.45 to 0.50). Testing rates were lower in 20–24-year-olds compared with 15–19-year-olds (OR 0.69; 95% CI 0.67 to 0.72 for females and OR 0.67; 95% CI 0.64 to 0.71 for males), but positivity was higher in older males.

Females were tested most often in healthcare services, which also identified the most positives. The greatest proportions of male tests were in university (27%) and military (19%) settings which only identified a total of 11% and 13% of total male positives respectively. More chlamydia-positive males were identified through healthcare services despite fewer numbers of tests.

Conclusions Testing of males focused on institutional settings where there is a low yield of positives, and limited capacity for expansion. By contrast, the testing of females, especially in urban environments, was mainly through established healthcare services. Future strategies should prioritise increasing male testing in healthcare settings.

Living improvement : a case study of a secondary school in England

Schools in England are being urged to personalize the curriculum and make school experiences more responsive to all students. We report on an evaluation project which investigated innovation in teaching and learning in a successful secondary school in the north of England. Data were gathered from a sample of teaching staff, a questionnaire to all students, lesson and meeting observations, and meetings with the governing body and parents: the student-guided evaluation canvassed recent and planned changes to the structure and experience of teaching and learning. This article illuminates how one school is breaking the ‘traditional schooling rules’ that limit improvement and how in doing so it is developing new insights about the nature and process of improvement. We show how staff and students have been engaged in the change process, and focus in particular on analysing the interplay between improvement as a plan, a practice and a lived experience.

A depth of data : research messages on the state of social work education in England

In the light of extensive media coverage of social work education, this article uses information from the Department of Health funded three-years multi-method evaluation of the social work degree qualification in England to discuss areas in which qualifying education might be improved. It argues that too great a concern with the 'A' level performance of social work applicants risks not paying enough attention to the non-academic qualities that they will need to work in the changing world of children's and adult services. Better partnership working between employers and universities will help students make the transition into the workplace. This includes greater opportunities for employers and practitioners to be involved in candidate selection and teaching on qualifying programmes.

Changes in admissions work arising from the new social work degree in England

The business of admissions to higher education in England is a significant task for academic and support staff. This paper draws on the Evaluation of the New Social Work Degree Qualification in England (2004-2008) to describe the changes in admissions work for social work staff in higher education associated with the change from diploma to a degree level qualification for entry to the profession; to report how staff involved in admissions work are managing these changes; and to identify elements of admissions processes that are perceived to be fulfilling the new requirements of the degree and those which are identified as more problematic. The article draws on two telephone/email surveys of a national sample of social work programmes and on face-to-face in-depth interviews with a sample of teaching staff from nine social work programmes in six higher education institutions undertaken during 2005-2007. The work of admissions staff is rarely scrutinised in studies of higher education or specifically in social work programmes: this article discusses the spectrum of approaches. It recommends monitoring of the outcomes of practices in admissions work that are recasting Department of Health Requirements as the minimum.

An index of unhealthy lifestyle is associated with coronary heart disease mortality rates for small areas in England after adjustment for deprivation

Indices of socio-economic deprivation are often used as a proxy for differences in the health behaviours of populations within small areas, but these indices are a measure of the economic environment rather than the health environment. Sets of synthetic estimates of the ward-level prevalence of low fruit and vegetable consumption, obesity, raised blood pressure, raised cholesterol and smoking were combined to develop an index of unhealthy lifestyle. Multi-level regression models showed that this index described about 50% of the large-scale geographic variation in CHD mortality rates in England, and substantially adds to the ability of an index of deprivation to explain geographic variations in CHD mortality rates.

Using vignettes to evaluate the outcomes of student learning : data from the evaluation of the new social work degree in England

This paper reports the use of vignettes as a methodology to analyse the extent to which the new social work degree programmes enabled students to develop their analytical and reflective capabilities. Two vignettes, which focused on children and families and adult social care respectively, were developed for the study. Students were asked to respond in writing, from the perspective of a social worker, to a standard set of questions at the beginning (T1) and end of their degree programme (T2). Considering the responses to all questions across the two vignettes, a series of scales was developed to measure the key themes which had been identified by qualitative analysis. These included ‘Attention to process of relationships’ and ‘Social/structural/political awareness’. Responses were also rated as ‘descriptive’, ‘analytic’ or ‘reflective’.

Students from six universities in England participated. From an original sample of 222 students, it was possible to match 79 T1 and T2 responses. Analysis of variance demonstrated statistically significant increases in nine of the 11 themes and increases in ratings for analysis and reflection.

In conclusion, vignettes can be used to produce both qualitative and quantitative data in respect of changes in students’ acquisition of knowledge and skills over time.