Design and delivery of a national pilot survey of capabilities

Understanding the numbers of people with different levels of ability in the population is important for informing design decisions for mainstream products, but a survey dataset for this purpose does not exist. This paper describes a key step towards obtaining such data. It describes a pilot survey of 362 people across England and Wales in preparation for a full national survey. Information was gathered on vision, hearing, hand and arm function, mobility, cognitive function, product use, psychological characteristics, anthropometrics and demographics. An interesting finding is that of those participants who reported any limitations in daily activities due to capability loss, 44% reported limitations due to loss of more than one capability. This finding highlights the importance of measuring multiple capabilities in a single survey. Top-level lessons learnt include: simplifying vision tests; reducing exclusion criteria for some of the tests; adopting a stratified sampling approach; and allocating more training for interviewers.This research was funded by the Engineering and Physical Sciences Research Council grant (Award Number: RG45089).This is the accepted version of the article. The final version is available fro Inderscience at http://inderscience.metapress.com/content/fk41618325n25741/

Brief cognitive assessment in a UK population sample – distributional properties and the relationship between the MMSE and an extended mental state examination

BACKGROUND: Despite the MMSE's known flaws, it is still used extensively as both a screening instrument for dementia and a population measure of cognitive ability. The aim of this paper is to provide data on the distribution of MMSE scores in a representative sample from the UK population and to compare it with an extended cognitive assessment (EMSE) which covers a wider range of cognitive domains and provides a wider range of difficulty levels. METHODS: The MMSE and the EMSE were administered to over 12,000 participants at the screening stage of the MRC Cognitive Function and Ageing Study (MRC CFAS). MRC CFAS is a multi-centre population-based study in England and Wales with respondents aged 65 years and older. RESULTS: Normative values on the MMSE and EMSE are presented by age group, sex and level of education. There are very large differences between age groups, with smaller differences seen between the sexes and by level of education. The EMSE extends the scores at the high end of the ability range, but is no better than the MMSE at differentiating between dementia and non-dementia. CONCLUSION: Population-derived norms are valuable for comparing an individual's score to the score that would be expected among the general population, given the individual's specific demographic characteristics

Happy to help? Exploring the factors associated with variations in rates of volunteering across Europe

The frequency of formal volunteering varies widely across European countries, and rates of formal volunteering are especially low among Eastern European countries. Why are there such large differences in volunteering rates when it is known that volunteering is beneficial for well-being? Using data from the latest round of the European Social Survey, we test three hypotheses to explain these cross-national differences in volunteering. We ask whether people in countries with low frequencies of volunteering spend more of their time on informal volunteering activities; whether they differ on socio-demographic variables which are known to be linked to volunteering rates; or whether they show less well-being benefit from formal volunteering. Contrary to the first hypothesis, we find a positive correlation between formal and informal volunteering. We further conclude that national differences in rates of volunteering cannot be fully explained by differences in the social, psychological or cultural factors associated with volunteering nor the outcome of volunteering. It is likely that contextual factors, such as a country’s historical background or institutions, determine levels of volunteering to a large extent

Wellbeing: The Challenge of ‘Operationalising’ an Holistic Concept within a Reductionist Public Health Programme

Background Wellbeing is a concept that, whilst contested, recognises individual and wider social, economic, political and environmental contextual influences – and is of growing interest and relevance locally and globally. In this paper, we report on one aspect of an evaluative research study conducted on a public health programme in North West England. Aims Within the context of a process evaluation that explored the delivery of a public health programme and sought to increase understanding of how and why different approaches worked well or not so well, this paper focuses specifically on the concept of wellbeing, examining perceptions of multiple stakeholders. Methods Interviews and focus groups were undertaken with 52 stakeholders involved in managing and facilitating the programme and its composite projects and with 90 community members involved as project participants. Data were subjected to thematic analysis, cross‐check and refining. Findings Findings highlight stakeholders’ diverse understandings of wellbeing, the complex relationship between health and wellbeing, and the perceived dissonance between the holistic concept of wellbeing and the reductionist design of the programme. Conclusions Wellbeing was understood to be ‘more than health’ and ‘more than happiness’, concerned with effective functioning, sense of purpose and flourishing. Essentially holistic, wellbeing offers opportunities to transcend clinical/pathogenic conceptions of ‘health’ and resonate with individuals, communities and local authorities. This raises concerns about how wellbeing can be meaningfully realised without compromising the concept, particularly when programmes are structured in reductionist ways requiring monitoring against discrete outcomes. Implications for practice include: utilising wellbeing as a driver for cross‐cutting public health in challenging economic and organisational contexts; acknowledging that wellbeing is essentially social as well as individual; appreciating that wellbeing is experienced in relation to contexts and surroundings; and recognising that wellbeing defined in terms of individual happiness risks compromising the future wellbeing of societies and the planet

The use of happiness research for public policy

Research on happiness tends to follow a "benevolent dictator" approach where politicians pursue people's happiness. This paper takes an antithetic approach based on the insights of public choice theory. First, we inquire how the results of happiness research may be used to improve the choice of institutions. Second, we show that the policy approach matters for the choice of research questions and the kind of knowledge happiness research aims to provide. Third, we emphasize that there is no shortcut to an optimal policy maximizing some happiness indicator or social welfare function since governments have an incentive to manipulate this indicator

Qualitative differences in psychiatric symptoms between high risk groups assessed on a screening test (GHQ-30)

Scores on five subscales derived from the GHQ-30 have been examined in various groups at risk for psychiatric disorder, to determine whether different patterns of symptoms are found. The subscales are based on a factor analysis of a population sample of over 6,000 adults (Huppert et al. 1989) which identified five robust factors corresponding to symptoms of anxiety, feelings of incompetence, depression, difficulty in coping and social dysfunction. Previous studies have identified certain groups of people who are vulnerable to mental illness and are therefore likely to obtain a high score on the GHQ. These include unemployed men, single women with dependent children, and elderly people in poor health. The results show marked differences in symptom patterns among these three at-risk groups. For example, while scores on anxiety and depression subscales were significantly raised in most at-risk groups, young unemployed men did not show significant anxiety whereas elderly men in poor health did not show significant depressive symptoms. However both these groups showed difficulty in coping, unlike older unemployed men or elderly women in poor health. Single women with dependent children reported the highest rate of psychiatric symptoms, particularly anxiety and depression, but had difficulty in coping only if they were also employed. These findings suggest that this method of analysing data from the GHQ-30 has potential value in yielding qualitative as well as quantitative information about psychiatric symptoms.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41738/1/127_2004_Article_BF00789216.pd

The impact of emotional well-being on long-term recovery and survival in physical illness: a meta-analysis

This meta-analysis synthesized studies on emotional well-being as predictor of the prognosis of physical illness, while in addition evaluating the impact of putative moderators, namely constructs of well-being, health-related outcome, year of publication, follow-up time and methodological quality of the included studies. The search in reference lists and electronic databases (Medline and PsycInfo) identified 17 eligible studies examining the impact of general well-being, positive affect and life satisfaction on recovery and survival in physically ill patients. Meta-analytically combining these studies revealed a Likelihood Ratio of 1.14, indicating a small but significant effect. Higher levels of emotional well-being are beneficial for recovery and survival in physically ill patients. The findings show that emotional well-being predicts long-term prognosis of physical illness. This suggests that enhancement of emotional well-being may improve the prognosis of physical illness, which should be investigated by future research