Creative approaches to mental health: a critical analysis of the mindfulness agenda in Sussex

Mindfulness is a packaged intervention with current popularity in East Sussex, and this study explores how it is embedded in mental health services, the processes of the gathering and presentation of evidence, how the experience of patients is organizationally shaped and the importance of indirect interventions. These forms of interventions are what has been termed ‘choice architecture’ by proponents of the ‘nudge agenda’, describing the way that decisions and behaviour are influenced by how the choices are presented or designed . I want to explore the feasibility of applying indirect interventions to mindfulness in order to increase take-up rates, evaluative mechanisms and follow-up support, based on the patient perspective. Mindfulness-based cognitive therapy (MBCT) was recommended by NICE in their guidelines in 2004, was brought fully into the mainstream and has now been specifically adapted for psychosis. My research is on the interaction between mindfulness as an innovative therapy, a marginalised group of people who experience psychosis, and the currently popular behavioural economics (nudge) agenda. The nudge agenda is being promoted on the basis of cost-effectiveness, the aptness of its ideology to the current political climate, and its evidence base in particular case studies. The use of creative indirect interventions such as nudge, ‘when carefully crafted and applied’, can be ‘a positive means of communication between physician and patient’

Comment: Citation Statistics

Comment on "Citation Statistics" [arXiv:0910.3529]Comment: Published in at http://dx.doi.org/10.1214/09-STS285C the Statistical Science (http://www.imstat.org/sts/) by the Institute of Mathematical Statistics (http://www.imstat.org

Gap distribution of Farey fractions under some divisibility constraints

For a fixed positive integer d, we show the existence of the limiting gap distribution measure for the sets of Farey fractions a/q of order Q with a not divisible by d, and respectively with q relatively prime with d, as Q tends to infinity.Comment: 15 pages, revised versio

Simple and Multistate Survival Curves

Objective and Sample: This investigation assessed the comprehension of survival curves in a community sample of 88 young and middle-aged adults when several aspects of good practice for graphical communication were implemented, and it compared comprehension for alternative presentation formats. Design, Method, and Measurements: After reading worked examples of using survival curves that provided explanation and answers, participants answered questions on survival data for pairs of treatments. Study 1 compared presenting survival curves for both treatments on the same figure against presentation via 2 separate figures. Study 2 compared presenting data for 3 possible outcome states via a single “multistate” figure for each treatment against presenting each outcome on a separate figure (with both treatments on the same figure). Both studies compared alternative forms of questioning (e.g., “number alive” versus “number dead”). Numeracy levels (self-rated and objective measures) were also assessed. Results: Comprehension was generally good—exceeding 90% correct answers on half the questions—and was similar across alternative graphical formats. Lower accuracy was observed for questions requiring a calculation but was significantly lower only when the requirement for calculation was not explicit (13%–28% decrements in performance). In study 1, this effect was most acute for those with lower levels of numeracy. Subjective (self-rated) numeracy and objective (measured) numeracy were both moderate positive predictors of overall task accuracy (r ≈ 0.3). Conclusions: A high degree of accuracy in extracting information from survival curves is possible, as long as any calculations that are required are made explicit (e.g., finding differences between 2 survival rates). Therefore, practitioners need not avoid using survival curves in discussions with patients, although clear and explicit explanations are important </jats:p

How old are you, really? Communicating chronic risk through 'effective age' of your body and organs.

In communicating chronic risks, there is increasing use of a metaphor that can be termed 'effective-age': the age of a 'healthy' person who has the same risk profile as the individual in question. Popular measures include 'real-age', 'heart-age', 'lung-age' and so on.Here we formally define this concept, and illustrate its use in a variety of areas. We explore conditions under which the years lost or gained that are associated with exposure to risk factors depends neither on current chronological age, nor the period over which the risk is defined. These conditions generally hold for all-cause adult mortality, which enables a simple and vivid translation from hazard-ratios to years lost or gained off chronological age. Finally we consider the attractiveness and impact of this concept.Under reasonable assumptions, the risks associated with specific behaviours can be expressed in terms of years gained or lost off your effective age. The idea of effective age appears a useful and attractive metaphor to vividly communicate risks to individuals.David and Claudia Harding Foundatio

Communicating statistics through the media in the time of Covid-19

Professor Kevin McConway and Professor Sir David Spiegelhalter discuss their experiences of communicating statistical research to the media and offer 12 tips for researchers to effectively engage with the media. The coronavirus pandemic has brought an unprecedented demand from the media for statistical commentary. Whereas a trip to a studio for a radio or TV interview was ... Continue

What Can Education Learn from Real-World Communication of Risk and Uncertainty?

Probability is a difficult topic to teach, not least because it is rather unclear what it actually means. Modern risk communication has tackled general public incomprehension of probability statements by using the metaphor of ‘expected frequencies’ – for example, “of 100 people like you, we would expect 10 to have a heart attack or stroke in the next 10 years.” We show how these ideas can be taken into the classroom as the basis for teaching probability, using frequency tree diagrams as the fundamental representation. Empirical frequency trees can be used to summarise a series of classroom experiments, and then expected frequency trees naturally provide a basis for deriving the rules of probability, and make complex conditional probability calculations reasonably straightforward

COVID in statistics: numbers do not speak for themselves

David Spiegelhalter (University of Cambridge) and Anthony Masters (Royal Statistical Society) highlight some of the key findings from their book, COVID by Numbers: Making Sense of the Pandemic with Data

Modelling bias in combining small area prevalence estimates from multiple surveys

Combining information from multiple surveys can improve the quality of small area estimates.Customary approaches, such as themultiple-frame and statistical matching methods, require individual level data, whereas in practice often only multiple aggregate estimates are available. Commercial surveys usually produce such estimates without clear description of the methodology that is used. In this context, bias modelling is crucial, and we propose a series of Bayesian hierarchical models which allow for additive biases. Some of these models can also be fitted in a classical context, by using a mixed effects framework. We apply these methods to obtain estimates of smoking prevalence in local authorities across the east of England from seven surveys. All the surveys provide smoking prevalence estimates and confidence intervals at the local authority level, but they vary by time, sample size and transparency of methodology. Our models adjust for the biases in commercial surveys but incorporate information from all the sources to provide more accurate and precise estimates