EMPOWERCARE: EMPOWERing individuals & communities to manage their own CARE

EMPOWERing individuals and communities to manage their own CARE (EMPOWERCARE) was a 3-year social innovation project involving 13 cross border European partners. EMPOWERCARE developed a holistic community asset approach to respond to current gaps in the care of people in the target group (those aged 65+ and those aged 50+ with at least one chronic condition). It aimed to address challenges facing our societies concerning the care of our ageing populations and when older people are not being involved in decisions concerning their own health and wellbeing. The project ensured that older people are at the forefront of improved technology and better care from within their communities. This sought to improve their situation but also tackle the financial issues of an ageing population and improve social cohesion. The main key messages from the evaluation of the project initiatives were: • Self-efficacy – Across all sites, ‘inactive’ participants at baseline showed a statistically significant increase in self-efficacy at the end of the initiatives. Qualitative data confirmed end-users’ increased levels of selfconfidence and self-efficacy around taking action in relation to their own health. • Emotional and social wellbeing - When considering all project sites, there was no significant decrease of the level of reported loneliness, overall and by type (emotional and social), for participants who reported feeling lonely at the start of the initiative. For participants from philosophically focused initiatives, who reported being lonely at the start of the initiative, there was a slight decrease in emotional loneliness from baseline, although this change was not statistically significant. Overall, there was no decrease, but for initiatives that were philosophically focused there was a negative trend. Qualitative data evidenced the positive impact initiatives had in tackling end-users’ loneliness. • Digital literacy - When analysing survey responses from all sites, end-users reported internet healthseeking behaviour did change at the end of initiatives. Nonetheless, for the sites focusing more on technology, internet health-seeking behaviour increased from baseline to end of initiative, although the positive change was not statistically significant. Qualitative data from end-users confirms the survey results that those participating in the initiatives felt more digitally literate and confident in using technology for their physical and mental health needs and to keep connected with their social networks. • Internet health-seeking behaviour – There was no significant change in this area for end-users. This could be explained by them receiving help in-person and therefore they felt less need to go online for help with their health. For technology focused initiatives there was still no significant change, but there was a positive trend for technology enthusiasm. Anxiety around technology use remained and the qualitative data relating to this indicated there was room to build on technology skills. • Person centred care - Across all sites, for those that had a baseline of below average person-centredness or lower, mean scores increased from baseline to end of initiatives, and this improvement was statistically significant, indicating that the project initiatives significantly increased workforce person-centeredness. There were also similar significant improvements in the specific areas of this scale of Climate of Safety, Climate of Everydayness, Climate of community and Climate of Comprehensibility, indicating that the project initiatives significantly increased workforce feelings of whether the workplace is a place where the patients are in safe hands, staff use language that the patients can understand, it is easy for patients to talk to the staff and where the patients have someone to talk to if they so wish. Qualitative data reflected these results, talking about the transformation in people’s lives that was possible through being focused on the needs of the individuals and what matters to them. • Workforce technology uptake - Across all sites, survey results from workforce attitudes towards technology did not show any change from baseline to end of initiatives. Similarly, there was no difference between workforce participants in technology-focused and philosophical initiatives. Qualitative data from the workforce showed an understanding of the need to embrace technology in their work and that some of the drive for that need came from the implementation of COVID-19 restrictions. • Job satisfaction and workforce training embeddedness – for job satisfaction there was no significant change, although there was a positive trend for those who started below the top 15%. The context of working through COVID-19 may have had a negative impact on job satisfaction. Across all sites, there were higher average scores on certain areas of efficacy in relation to workforce training in implementing, embedding, and integrating a complex healthcare initiative, such as reflective monitoring and collective action compared to coherence, and cognitive participation findings suggest that overall workforce members showed they are willing to engage in reflexive monitoring and collective action across all sites – so they were willing to self-monitor and take time to think about their behaviour and work together to take action. The qualitative data indicated that embedding training has enabled the workforce to understand the value of taking time, reflecting and connecting, which are some of the key person-centred competencies and attributes you would want to see in a transformed workforce. The Cost Benefit Analysis showed: • Contingent Valuation Method (CVM) evaluation indicate that individuals are willing to pay (WTP) on average €10.31 per month from their own out of pocket expenses to use and obtain the health benefits and wellbeing effects of participating in the EMPOWERCARE initiatives. • WTP is positively influenced by the value individuals place on the technically focused initiatives, willingness to participate in an alternative initiative along with improvements gained in emotional and social loneliness because of the EMPOWERCARE initiatives. • The WTP estimates defined in this evaluation provide significant insights for decision makers and healthcare commissioners on the value that previous participants place on the services provided through the EMPOWERCARE initiatives in local communities. • Insights from the ‘Good Ancestor’ principles in FGD promotes the deliberation of long-term thinking which can lead to the power of change, reshaping decisions to take account of future generations, while promoting and encouraging sustainability in respect for future generations. The evaluation results provide some positive results on the success of the EMPOWERCARE initiatives across the 4 countries. More analysis has been done per site to understand the different aspects of the EMPOWERCARE Strategy, Workforce Transformation Package and Technology Blueprint that made a positive difference to end-users and members of the workforce. This further analysis will provide a more comprehensive picture of the impact of the EMPOWERCARE initiatives, as well as inform the next stages of work

Interfacing GHz-bandwidth heralded single photons with a room-temperature Raman quantum memory

Photonics is a promising platform for quantum technologies. However, photon sources and two-photon gates currently only operate probabilistically. Large-scale photonic processing will therefore be impossible without a multiplexing strategy to actively select successful events. High time-bandwidth-product quantum memories - devices that store and retrieve single photons on-demand - provide an efficient remedy via active synchronisation. Here we interface a GHz-bandwidth heralded single-photon source and a room-temperature Raman memory with a time-bandwidth product exceeding 1000. We store heralded single photons and observe a clear influence of the input photon statistics on the retrieved light, which agrees with our theoretical model. The preservation of the stored field's statistics is limited by four-wave-mixing noise, which we identify as the key remaining challenge in the development of practical memories for scalable photonic information processing

Are HIV smartphone apps and online interventions fit for purpose?

Sexual health is an under-explored area of Human-Computer Interaction (HCI), particularly sexually transmitted infections such as HIV. Due to the stigma associated with these infections, people are often motivated to seek information online. With the rise of smartphone and web apps, there is enormous potential for technology to provide easily accessible information and resources. However, using online information raises important concerns about the trustworthiness of these resources and whether they are fit for purpose. We conducted a review of smartphone and web apps to investigate the landscape of currently available online apps and whether they meet the diverse needs of people seeking information on HIV online. Our functionality review revealed that existing technology interventions have a one-size-fits-all approach and do not support the breadth and complexity of HIV-related support needs. We argue that technology-based interventions need to signpost their offering and provide tailored support for different stages of HIV, including prevention, testing, diagnosis and management

Reviewing research evidence and the case of participation in sport and physical recreation by black and minority ethnic communities

The paper addresses the implications of using the process of systematic review in the many areas of leisure where there is a dearth of material that would be admitted into conventional Cochrane Reviews. This raises important questions about what constitutes legitimate knowledge, questions that are of critical import not just to leisure scholars, but to the formulation of policy. The search for certainty in an area that lacks conceptual consensus results in an epistemological imperialism that takes a geocentric form. While clearly, there is a need for good research design whatever the style of research, we contend that the wholesale rejection of insightful research is profligate and foolhardy. A mechanism has to be found to capitalise on good quality research of whatever form. In that search, we draw upon our experience of conducting a review of the material available on participation in sport and physical recreation by people from Black and minority ethnic groups. The paper concludes with a proposal for a more productive review process that makes better use of the full panoply of good quality research available. © 2012 © 2012 Taylor & Francis

Who uses NHS health checks? Investigating the impact of ethnicity and gender and method of invitation on uptake of NHS health checks

Background NHS Health Checks is a national risk assessment prevention programme for all individuals aged 40-74 that reside in England. Through the systematic assessment of an individual’s ten year disease risk, this programme aims to provide early identification and subsequent management of this risk. However, there is limited evidence on how socio-demographic factors impact on uptake and what influence the invitation method has on uptake to this programme. Methods NHS Health Check data from April 2013 to March 2014 was analysed (N = 50,485) for all 30 GP Practices in Luton, a culturally diverse town in England, UK. Data was collected for age, ethnicity, uptake (attendance and non attendance) and invitation method (letter written, verbal face-to-face, telephone). Actual usage of NHS Health Checks was determined for each ethnic group of the population and compared using Chi-square analysis. Results The overall uptake rate for Luton was 44 %, markedly lower that the set target of 50–75 %. The findings revealed a variation of uptake in relation to age, gender, level of deprivation. Ethnicity and gender variations were also found, with ‘White British’ ‘Black Caribbean’ and ‘Indian’ patients most likely to take up a NHS Health Check. However, patients from ‘Any Other White Background’ and ‘Black African’ were significantly less likely to uptake an NHS Health Check compared to all other ethnic groups. Ethnicity and gender differences were also noted in relation to invitation method. Conclusions The findings revealed that different invitation methods were effective for different ethnic and gender groups. Therefore, it is suggested that established protocols of invitation are specifically designed for maximizing the response rate for each population group. Future research should now focus on uncovering the barriers to uptake in particular culturally diverse population groups to determine how public health teams can better engage with these communities

Initial ecological recovery post‐weir removal amidst catchment‐wide improvements, in a groundwater‐dominated chalk stream

Physical habitat modification is one of the main pressures affecting river environments, impacting their ecosystem health and compromising their ability to adapt to the effects of climate change. Addressing the impacts of physical modification through reinvigorating natural processes has become a globally established river restoration technique. Here, we appraised such an approach by assessing ecological responses to a weir removal project on an English groundwater‐dominated ‘chalk’ stream. Using a Before‐After‐Control‐Impact (BACI) approach, we found that 3 years post‐restoration the macroinvertebrate communities are moving towards those of the target community both in terms of structural complexity (e.g., taxonomic composition) and functional integrity (e.g., trait composition). The progress is ongoing and has occurred alongside wider catchment improvements. Our results indicate that ecological responses to passive restoration undertaken on low energy streams, such as chalk streams, may be gradual, and thus longer‐term assessment is needed to fully appraise ecological recovery. We highlight the importance of a BACI approach to understand the local responses to restoration in a catchment context. Our findings also provide further evidence highlighting complementary ecological information provided by assessing taxonomic and functional properties concurrently in post‐project appraisals. A better understanding of ecological recovery times should be incorporated into future restoration planning. Such evidence would help develop robust assessments over appropriate timescales, increasing the likelihood of accurately and effectively appraising restoration project success, and helping to build support to increase the scale and pace of restoration actions needed to address biodiversity loss

First Application of Pulse-Shape Analysis to Silicon Micro-Strip Detectors

The method of pulse-shape analysis (PSA) for particle identification (PID) was applied to a double-sided silicon strip detector (DSSD) with a strip pitch of 300 \{mu}m. We present the results of test measurements with particles from the reactions of a 70 MeV 12C beam impinging on a mylar target. Good separation between protons and alpha particles down to 3 MeV has been obtained when excluding the interstrip events of the DSSD from the analysis.Comment: 7 pages, 6 figures, submitted to Nuclear Inst. and Methods in Physics Research

Inferred changes in El Niño–Southern Oscillation variance over the past six centuries

It is vital to understand how the El Niño–Southern Oscillation (ENSO) has responded to past changes in natural and anthropogenic forcings, in order to better understand and predict its response to future greenhouse warming. To date, however, the instrumental record is too brief to fully characterize natural ENSO variability, while large discrepancies exist amongst paleo-proxy reconstructions of ENSO. These paleo-proxy reconstructions have typically attempted to reconstruct ENSO's temporal evolution, rather than the variance of these temporal changes. Here a new approach is developed that synthesizes the variance changes from various proxy data sets to provide a unified and updated estimate of past ENSO variance. The method is tested using surrogate data from two coupled general circulation model (CGCM) simulations. It is shown that in the presence of dating uncertainties, synthesizing variance information provides a more robust estimate of ENSO variance than synthesizing the raw data and then identifying its running variance. We also examine whether good temporal correspondence between proxy data and instrumental ENSO records implies a good representation of ENSO variance. In the climate modeling framework we show that a significant improvement in reconstructing ENSO variance changes is found when combining information from diverse ENSO-teleconnected source regions, rather than by relying on a single well-correlated location. This suggests that ENSO variance estimates derived from a single site should be viewed with caution. Finally, synthesizing existing ENSO reconstructions to arrive at a better estimate of past ENSO variance changes, we find robust evidence that the ENSO variance for any 30 yr period during the interval 1590–1880 was considerably lower than that observed during 1979–2009

Improved cross-validation for classifiers that make algorithmic choices to minimise runtime without compromising output correctness

Our topic is the use of machine learning to improve software by making choices which do not compromise the correctness of the output, but do affect the time taken to produce such output. We are particularly concerned with computer algebra systems (CASs), and in particular, our experiments are for selecting the variable ordering to use when performing a cylindrical algebraic decomposition of $n$-dimensional real space with respect to the signs of a set of polynomials. In our prior work we explored the different ML models that could be used, and how to identify suitable features of the input polynomials. In the present paper we both repeat our prior experiments on problems which have more variables (and thus exponentially more possible orderings), and examine the metric which our ML classifiers targets. The natural metric is computational runtime, with classifiers trained to pick the ordering which minimises this. However, this leads to the situation were models do not distinguish between any of the non-optimal orderings, whose runtimes may still vary dramatically. In this paper we investigate a modification to the cross-validation algorithms of the classifiers so that they do distinguish these cases, leading to improved results.Comment: 16 pages. Accepted into the Proceedings of MACIS 2019. arXiv admin note: text overlap with arXiv:1906.0145