Factor analysis of treatment outcomes from a UK specialist addiction service:relationship between the Leeds Dependence Questionnaire, Social Satisfaction Questionnaire and 10-item Clinical Outcomes in Routine Evaluation

INTRODUCTION AND AIMS: To examine the relationship between three outcome measures used by a specialist addiction service (UK): the Leeds Dependence Questionnaire (LDQ), the Social Satisfaction Questionnaire (SSQ) and the 10-item Clinical Outcomes in Routine Evaluation (CORE-10). DESIGN AND METHOD: A clinical sample of 715 service user records was extracted from a specialist addiction service (2011) database. The LDQ (dependence), SSQ (social satisfaction) and CORE-10 (psychological distress) were routinely administered at the start of treatment and again between 3 and 12 months post-treatment. A mixed pre/post-treatment dataset of 526 service users was subjected to exploratory factor analysis. Parallel Analysis and the Hull method were used to suggest the most parsimonious factor solution. RESULTS: Exploratory factor analysis with three factors accounted for 66.2% of the total variance but Parallel Analysis supported two factors as sufficient to account for observed correlations among items. In the two-factor solution, LDQ items and nine of the 10 CORE-10 items loaded on the first factor >0.41, and the SSQ items on factor 2 with loadings >0.63. A two dimensional summary appears sufficient and clinically meaningful. DISCUSSION AND CONCLUSIONS: Among specialist addiction service users, social satisfaction appears to be a unique construct of addiction and is not the same as variation due to psychological distress or dependence. Our interpretation of the findings is that dependence is best thought of as a specific psychological condition subsumed under the construct psychological distress. [Fairhurst C, Böhnke JR, Gabe R, Croudace TJ, Tober G, Raistrick D. Factor analysis of treatment outcomes from a UK specialist addiction service: Relationship between the Leeds Dependence Questionnaire, Social Satisfaction Questionnaire and 10-item Clinical Outcomes in Routine Evaluation. Drug Alcohol Rev 2014;33:643–650

Role Of Digital Health Wearables In The Wellbeing And Quality Of Life Of Older People And Carers

The number of adults aged 65 and over has increased by 2% across Europe in the past 15 years, and in Northern Ireland by 22% between 2003-2013. The proportion of the population in this age group is projected to increase by 63% to just under 0.5 million by 2033 – which will be a quarter of the population in Northern Ireland. Given Northern Ireland’s Active Ageing Strategy (2015-2021), there is an increasing focus on encouraging physical activity as we get older to preserve mobility and motor skills, and to enjoy the benefits of living longer and to minimise health problems associated with ageing. Over the last two years, we have been investigating the role of wearable activity tracking technologies in self-monitoring of activity by people aged over 55. Example technologies include activity trackers from Fitbit, Garmin and Samsung, and smart watches. Typically, these devices record steps walked, sleep patterns, calories expended and heart rate. Based on empirical investigations, this policy paper describes the benefits of activity monitors for people aged over 55 for self-monitoring of physical activity, for adopting healthy lifestyles, and for increasing or maintaining physical activity as a way to avoid high blood pressure, obesity, diabetes, and other medical conditions associated with weight or lower physical activity. It outlines the role of activity trackers in post-operative monitoring of mobility during rehabilitation, in caring, and for possible use of the data for diagnosis and medical interventions. It then discusses the challenges for adoption of these technologies, given currently, off-the-shelf devices are designed and calibrated for use by physically fit (typically young active people) with unrealistic fitness targets for the older generation

Investigating the influence of wearable activity - tracking technologies on behaviour change in people aged 55 and over

Our research project (http://www.shaileyminocha.info/digital-health-wearables/) at UK’s Open University and in collaboration with Age UK Milton Keynes aims to investigate whether behaviour changes in people aged over 55 years through the use of wearable activity-tracking technologies. Example technologies include those from Fitbit, Jawbone, or smart watches from Apple or Samsung. Typically, these devices record steps walked, sleep patterns, or calories expended.    The benefits of regular physical activity for older adults and those with chronic disease and/or mobility limitations are indisputable. Regular physical activity attenuates many of the health risks associated with obesity, cardiovascular disease, diabetes, depression and anxiety, and cognitive decline. As physical activity levels among older adults (both with and without chronic disease) are low, facilitating an increase in activity levels is an important public health issue. Walking has been identified as an ideal means of low-impact, low-risk physical activity that can boost physical and mental wellbeing. An author of a recent study said: “Physical activity may create a ‘reserve’ that protects motor abilities against the effects of age-related brain damage”. Walking has been shown to improve cognitive performance in older people. Our previous research has shown that walking with others can help reduce social isolation and loneliness among people aged 55 and over. In our year-long project (May 2016 – April 2017) and funded by the Sir Halley Stewart Trust, we have given activity-trackers to 17 participants in the age range from 55 – 80. Through monthly workshops, diaries that the participants are maintaining and sharing with us on a weekly basis, and through one-to-one interviews with them, we are investigating how the behaviours of our participants is changing – whether there is an increase in their activity such as walking or gardening, lifestyle changes, attitudes towards food/diet, and so on. There is already some evidence emerging such as: increase in activity levels in all the participants; increased awareness of food intake; and sharing of data with the GPs to diagnose the non-optimal sleep patterns (one of them now has a treatment plan in place for poor sleep). A couple of participants have joined the gym when they realised that their desk-based work-life doesn’t give them the opportunity to stay active during the week. In addition, we have conducted two surveys: the first survey is aimed at people aged 55 years and over who are already using these devices - to investigate their experiences and the changes in their behaviours that they perceive; and the second survey is aimed at medical professionals to explore whether they use the data from these devices for diagnosis and intervention. Most importantly, do medical professionals use data from these devices to determine the behaviour or lifestyle changes in people aged over 55 years? The Open University's Human Research Ethics Committee has approved the research design of this project (HREC/2016/2191/Minocha/1)

Magnitude Judgements Are Influenced by the Relative Positions of Data Points Within Axis Limits

When visualising data, chart designers have the freedom to choose the upper and lower limits of numerical axes. Axis limits can determine the physical characteristics of plotted values, such as the physical position of data points in dot plots. In two experiments (total N=300), we demonstrate that axis limits affect viewers' interpretations of the magnitudes of plotted values. Participants did not simply associate values presented at higher vertical positions with greater magnitudes. Instead, participants considered the relative positions of data points within the axis limits. Data points were considered to represent larger values when they were closer to the end of the axis associated with greater values, even when they were presented at the bottom of a chart. This provides further evidence of framing effects in the display of data, and offers insight into the cognitive mechanisms involved in assessing magnitude in data visualisations

The UK and the Arctic: Forward defence

The United Kingdom (UK) is not an Arctic state, but over the past decade its policies towards the region have developed in significant ways. Since 2013 the British Government has published two Arctic Policy Frameworks, setting out commitments to working cooperatively with the Arctic states and other stakeholders to ensure that as climate change occurs the region remains peaceful. In 2019, the Ministry of Defence (MOD) committed to publishing an Arctic Defence Strategy, that would “put the Arctic and the High North central to the security of the United Kingdom”. This article examines the evolution of UK defence interests in the Arctic, whilst also highlighting the emergence of a significant Scottish dimension in UK Arctic affairs.</div

Social isolation and loneliness in people aged 55 and over in Milton Keynes: the way forward

The Ageing Well and Living Well Scoping Workshop was organised by Gail Addison, Head of Public Health – Delivery, People Directorate, Milton Keynes Council in collaboration with Age UK Milton Keynes. The aims of the workshop were to: • Explore the connectivity between the Health and Wellbeing Board (HWB) and existing Partnership and Programme Boards across Milton Keynes • Explore the remit of the Partnership and Programme Boards in order to identify commonalities and fit with the HWB Board’s Strategic Implementation Plan and Priorities, including; • Social Isolation (Priority focus for Ageing Well partnership) • Reducing Obesity (Priority focus for Living Well partnership) • Identify next steps and commitment to action At this workshop, Professor Shailey Minocha of The Open University along with Jane Palmer, CEO, Age UK Milton Keynes led the track on social isolation and loneliness in people aged over 55 years in Milton Keynes. We highlighted the effects of social isolation and loneliness on the well-being and quality of life of people. For example, individuals lacking social contact carry a health risk equivalent to smoking up to 15 cigarettes in a day. We discussed the societal impacts of social isolation such as increased use of health and social care services, higher number of emergency admissions and GP consultations, slower discharge from hospitals which causes pressure on financial resources and health services. We outlined the risk factors of social isolation and particularly in the context of Milton Keynes. Drawing on from our report (http://oro.open.ac.uk/43925/), we emphasised the challenges for the community and for older people due to the increasing population of older people in Milton Keynes. We presented possible solutions for addressing the problem of social isolation and loneliness in Milton Keynes in three categories: one-to-one interventions (e.g. visits by community home visitors, regular phone conversations, visits by neighbours); group interventions (e.g. Men in sheds, lunch clubs, coffee mornings, inter-generational initiatives – for example, learning to get online, walking groups, local history society) and wider community and neighbourhood interventions such as encouraging older people to be volunteers; co-designing the programmes with older people - e.g. neighbouhood watch programmes and design of age-friendly design of spaces – local neighbourhoods and city centre in Milton Keynes