The benefits of giving: a study of learning in the fourth age and the role of volunteer learning mentors

Learning for the Fourth Age (L4A) is a social enterprise which recruits, trains, places and matches volunteers (‘learning mentors’) to older people living in care settings or domiciliary settings. Older people and volunteers form partnerships which develop around a focus for learning and areas of interest identified by the older person. L4A promotes the value of education as a tool for increasing wellbeing in later life and its vision is to improve quality of life through mental, social and emotional stimulation tailored towards vulnerable older people. We report on the findings of an independent evaluation, drawing on funding from the Big Lottery Silver Dreams programme. Over 12 months, using an agreed protocol, qualitative interviews with 69 people focused on five key areas determined by the organisation. Interviews included older people; learning mentors (the volunteers); L4A staff and directors; staff from care homes; and other stakeholders. Key records and documents relevant to the evaluation were examined. Our presentation focuses on key findings from the generative aspects of L4A’s work by highlighting the rich experiences of learning mentors who were unexpected mutual beneficiaries of L4A’s work. Learning mentors offer a unique contribution distinct from traditional befriending and through their relationships with older people demonstrated the importance of learning interventions in achieving more transformational outcomes. The extent of reciprocity and generativity identified further challenged stereotypes of older people’s contribution to social relationships. Further, for those learning mentors still studying, the experience had unexpected benefits – encouraging some to change their future career intentions, life choices and courses as well as employability. We encountered changes in career intentions, course intentions, changed family behaviours, changed work behaviours, and reflective comments on end of life experiences that were clearly life changing. Increased opportunities for networking became a demand from mentors, who recognised their own learning and the links between altruism and reciprocity. This paper aims to stimulate further debate about the complexity of the landscape in which members of the community interact with opportunities to volunteer and the challenge to capitalise on their contributions to transgress more traditional notions about volunteering embedded in policy. The audience will be encouraged to consider the implications for both training and supporting volunteers to capitalise on their contributions and to reconside

Quality improvement through the paradigm of learning

Purpose - If we are to achieve meaningful participation and co-production for older people in care, more radical approaches are required. This project explores an innovation where older people using social care were matched to community based learning mentors to develop partnerships within which learning interventions were facilitated. We explore how the concept of learning might be used as a paradigm to raise the quality of care in institutionalised settings using a co-productive and relationship based approach to promote wellbeing. Design/methodology/approach - A structured evaluation drew on qualitative data captured from interviews with older people (n=25) and learning mentors (n=22) to reflect on the potential benefits and challenges involved when introducing learning interventions in care settings. This was contextualised alongside data captured from stakeholders (n=10) including a care home manager, social care and education commissioners, Trustees and project staff to assess the interdisciplinary contribution of lifelong learning to quality improvement. Findings - Introducing learning interventions to older people within care settings promoted participation, advocacy and relationship-based care which in turn helped to create a positive culture. Given the current challenges to improve quality in care services, drawing on a paradigm of learning may encourage older people to retain their independence as care homes strive towards a person-centred approach. Promoting social activities and leisure using learning was found to foster closer working relationships between older people and the wider community. These had a levelling effect through reciprocity, using an asset based approach. There were benefits for the care provider as the partnerships formed enabled people to raise both individual and collective concerns about care and support. Originality/value - Raising and sustaining the quality of support for older people requires input from the wider public sector beyond health and social care. Purposeful engagement with other disciplines such as learning and leisure offers the potential to realise a more sustainable model of user choice, person-centred support and user involvement. Being engaged through learning can nourish membership in the community for marginalised populations such as older people living in care homes

Beta-blocker under-use in COPD patients

Background: Cardiovascular (CVS) comorbidities are common in COPD and contribute significantly to morbidity and mortality, especially following acute exacerbations of COPD (AECOPD). Beta-blockers (BBs) are safe and effective in COPD patients, with demonstrated survival benefit following myocardial infarction. We sought to determine if BBs are under-prescribed in patients hospitalized with AECOPD. We also sought to determine inpatient rates of CVS and cerebrovascular complications, and their impact on patient outcomes. Methods: Retrospective hospital data was collected over a 12-month period. The medical records of all patients 40 years of age coded with a diagnosis of AECOPD were analyzed. Prevalent use and incident initiation of BBs were assessed. Comorbidities including indications and contraindications for BB use were analyzed. Results: Of the 366 eligible patients, 156 patients (42.6%) had at least one indication for BB use – of these patients, only 53 (34.0%) were on BB therapy and 61 (39.1%) were not on BB therapy but had no listed contraindication. Prevalent use of BBs at the time of admission in all 366 patients was 19.7%, compared with 45.6%, 39.6% and 45.9% use of anti-platelets, statins and angiotensin-converting enzyme inhibitor/angiotensin II receptor blockers, respectively. CVS and cerebrovascular complications were common in this population (57 patients, 16%) and were associated with longer length of stay (p,0.01) and greater inpatient mortality (p=0.02). Conclusions: BBs are under-prescribed in COPD patients despite clear indication(s) for their use. Further work is required to explore barriers to BB prescribing in COPD patients

Diagnostic classification based on DNA methylation profiles using sequential machine learning approaches

Aberrant methylation patterns in human DNA have great potential for the discovery of novel diagnostic and disease progression biomarkers. In this paper we used machine learning algorithms to identify promising methylation sites for diagnosing cancerous tissue and to classify patients based on methylation values at these sites. We used genome-wide DNA methylation patterns from both cancerous and normal tissue samples, obtained from the Genomic Data Commons consortium and trialled our methods on three types of urological cancer. A decision tree was used to identify the methylation sites most useful for diagnosis. The identified locations were then used to train a neural network to classify samples as either cancerous or non-cancerous. Using this two-step approach we found strong indicative biomarker panels for each of the three cancer types. These methods could likely be translated to other cancers and improved by using non-invasive liquid methods such as blood instead of biopsy tissue

Fluorescent analysis of photosynthetic microbes and Polycyclic Aromatic Hydrocarbons linked to optical remote sensing

Fluorescence analysis, being a non-invasive technique, has become one of the most powerful and widely used techniques for microbiologists and chemists to study various types of sample from photosynthetic microbes to hydrocarbons. The work reported here focuses on experimental results of fluorescent features of photosynthetic microbial species (cyanobacteria) and also five different crude oil samples. The cyanobacteria samples were collected from the Baltic Sea at the end of July 2011 and were associated with cyanobacterial bloom events, and the crude oil samples were from various oil spill events. The aim of the study was to find fluorescent biosignatures of cyanobacteria (initially a species specific to the Baltic Sea) and the fingerprints of crude oil; oil spills can be difficult to differentiate from biogenic films when using Synthetic Aperture Radar (SAR) or sunglint contaminated optical imagery. All samples were measured using a Perkin Elmer LS55 Luminescence spectrometer over a broad range of excitation and emission wavelength from ultraviolet (UV) to near infrared (NIR). The results are presented in Excitation Emission Matrices (EEMs) that exhibit the fluorescent features of each sample. In the EEM of the seawater sample containing cyanobacteria, there is an intense emission peak from tryptophan with fluorescent excitation and emission peaks at 285 and 345 nm respectively. In addition, fluorescent signatures of phycocyanin and chlorophyll-a are present with excitation and emission centre wavelengths at 555 nm, 645 nm and 390 nm, 685 nm, respectively. Additionally, the fluorescence signatures of Polycyclic Aromatic Hydrocarbons (PAHs) are present in the EEMs of crude oil samples with excitation and emission peaks at 285 nm and 425 nm. This study underpins further research on how to distinguish cyanobacteria species by their fluorescence signatures and the potential role that PAHs play in detection of cyanobacteria fluorescence features

Preliminary dose comparisons for the MRS Systems Study

This report provides preliminary information on the radiological doses to the public and the workers for alternative system configurations proposed in the MRS Systems Study. Information published in the MRS Environmental Assessment (DOE 1986) was used as a basis for this analysis. The risk differences between alternative configurations were found to be small and should not be viewed as a major factor in selecting alternative configurations. 1 ref

Spatial and temporal variation in the effects of climatic variables on Dugong calf production

Knowledge of the relationships between environmental forcing and demographic parameters is important for predicting responses from climatic changes and to manage populations effectively. We explore the relationships between the proportion of sea cows (Dugong dugon) classified as calves and four climatic drivers (rainfall anomaly, Southern Oscillation El Niño Index [SOI], NINO 3.4 sea surface temperature index, and number of tropical cyclones) at a range of spatially distinct locations in Queensland, Australia, a region with relatively high dugong density. Dugong and calf data were obtained from standardized aerial surveys conducted along the study region. A range of lagged versions of each of the focal climatic drivers (1 to 4 years) were included in a global model containing the proportion of calves in each population crossed with each of the lagged versions of the climatic drivers to explore relationships. The relative influence of each predictor was estimated via Gibbs variable selection. The relationships between the proportion of dependent calves and the climatic drivers varied spatially and temporally, with climatic drivers influencing calf counts at sub-regional scales. Thus we recommend that the assessment of and management response to indirect climatic threats on dugongs should also occur at sub-regional scales. © 2016 Fuentes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Capacity building to reduce maternal and neonatal morbidity and mortality

In sub-Saharan Africa midwifery educators are in short supply and opportunities to pursue advanced education are severely restricted. Postgraduate programmes that encourage critical thinking and strategic planning in midwifery education, practice, management and research are required to empower midwives to lead their profession. A unique user-led distance learning programme was developed by adopting a participatory approach to developing a curriculum for a Masters in Midwifery and Women's Health. Midwives from the East Central and South Africa (ECSA) region and the UK participated along with a representative from the Commonwealth Secretariat and International Confederation of Midwives (ICM). The curriculum was based on shared goals but adaptable to cultural and local context. Brainstorming sessions, informal workshops and formal consensus methods were used to reach decisions regarding modules and subsequent content. This article describes the process of developing a shared curriculum, the challenges faced in working across and within regions, and participants’ views of contributing to the end product. </jats:p