What Have We Learned in Five Decades of Neutralization Research?

Neutralization theory, though a popular framework for understanding deviant behavior, remains badly underdeveloped. Few attempts have been made to connect it to narrative and sociocognitive research in psychology and related fields. From this wider perspective, one reason neutralization theory has received only mixed empirical support is that it has been understood as a theory of criminal etiology. This makes little sense (how can one neutralize something before they have done it?) and makes the theory difficult to test. Neutralization should instead be seen as playing a role in persistence in or desistance from criminal behavior. The theory's central premises need to be substantially complicated. The notions that all excuses or justifications are "bad" and that reform involves "accepting complete responsibility" for one's actions are not tenable.

The contribution of qualitative research in designing a complex intervention for secondary prevention of coronary heart disease in two different healthcare systems

Background: Developing complex interventions for testing in randomised controlled trials is of increasing importance in healthcare planning. There is a need for careful design of interventions for secondary prevention of coronary heart disease (CHD). It has been suggested that integrating qualitative research in the development of a complex intervention may contribute to optimising its design but there is limited evidence of this in practice. This study aims to examine the contribution of qualitative research in developing a complex intervention to improve the provision and uptake of secondary prevention of CHD within primary care in two different healthcare systems.

Methods: In four general practices, one rural and one urban, in Northern Ireland and the Republic of Ireland, patients with CHD were purposively selected. Four focus groups with patients (N = 23) and four with staff (N = 29) informed the development of the intervention by exploring how it could be tailored and integrated with current secondary prevention activities for CHD in the two healthcare settings. Following an exploratory trial the acceptability and feasibility of the intervention were discussed in four focus groups (17 patients) and 10 interviews (staff). The data were analysed using thematic analysis.

Results: Integrating qualitative research into the development of the intervention provided depth of information about the varying impact, between the two healthcare systems, of different funding and administrative arrangements, on their provision of secondary prevention and identified similar barriers of time constraints, training needs and poor patient motivation. The findings also highlighted the importance to patients of stress management, the need for which had been underestimated by the researchers. The qualitative evaluation provided depth of detail not found in evaluation questionnaires. It highlighted how the intervention needed to be more practical by minimising administration, integrating role plays into behaviour change training, providing more practical information about stress management and removing self-monitoring of lifestyle change.

Conclusion: Qualitative research is integral to developing the design detail of a complex intervention and tailoring its components to address individuals' needs in different healthcare systems. The findings highlight how qualitative research may be a valuable component of the preparation for complex interventions and their evaluation.

Economic cost of age-related macular degeneration: a review of recent research

As the population of most developed countries ages so the prevalence of diseases such as age-related macular degeneration (AMD) are likely to increase. To facilitate planning and informed debate regarding making provisions for this disease it is important that we have a clear understanding of the economic impact of visual impairment associated with AMD. In this paper we assess the state of current knowledge based on a review of published evidence in scientific journals. Based on our assessment of the evidence we argue that the paucity of research studies on the subject and wide variation in estimates produced from the few studies available make it difficult to assess with confidence the likely average direct cost-of-illness associated with AMD. We further argue that significant gaps in our understanding of the costs of AMD (particularly in respect of indirect costs) also exist. Current research should be augmented by more comprehensive studies.

Governance and charities: An exploration of key themes and the development of a research agenda

The concept of governance has been widely discussed in both the business and non-business sectors. The debate has also been entered into within the charity sector, which comprises over 169,000 organizations in the UK. The UK-based Charity Commission, which describes itself as existing to ‘promote sound governance and accountability’, has taken a lead in this debate by promoting greater regulation and producing numerous recommendations with regard to the proper governance of charitable organizations. However, the concept of what is meant by governance is unclear and a myriad of ideas are placed under the umbrella of ‘good governance’. This paper explores the major themes that form the basis of much of this discussion, examining both the theoretical underpinnings and empirical investigations relating to this area (looking from the perspective of the key stakeholders in the charity sector). Based on an analysis of the extant literature, this paper presents a broad definition of governance with respect to charities and outlines a future research agenda for those interested in adding to knowledge in this area.