Using whole body technologies to map the mobility of older adults

In this paper we describe the preliminary findings of two-year study that attempted to map the mobility of our oldest citizens using activity monitoring and location-aware technologies. We recruited a group of 100 adults aged between 72 and 92 years old, drawn from a 25 year longitudinal cohort, and collected lifestyle, nutrition, health and social engagement data. We also fitted a subset of the group with accelerometers and location-based tracking devices and asked them to wear these for a week in order that we could generate accurate, live mobility data and assess these data against self-reports. We are now using this data to describe the relationship between mobility, activity and physical and mental well-being, but in this preliminary paper, we outline some of the main challenges we encountered when trying to use these ‘whole body’ technologies to determine mobility

New academics’ experiences of induction to teaching: an Activity Theory approach

In this article we present findings of a research project investigating the experiences of new academics in the process of becoming effective teachers, using an Activity Theory framework (Engestrom, 2001 ). The research was undertaken in a post-92 university that has shifted from teaching and professional development to prioritise a new emphasis on research. However, all academics have a dual responsibility for teaching and research. The project brought us together as education developers who were involved in the induction of academics into teaching across six departments. We shared a common aim in trying to understand the issues faced by new academics in their various disciplines and departments, in order to improve their induction experience and provide an enhanced CPD offer

Location tracking: views from the older adult population

Background: there has been a rise in the use of social media applications that allow people to see where friends, family and nearby services are located. Yet while uptake has been high for younger people, adoption by older adults is relatively slow, despite the potential health and social benefits. In this paper, we explore the barriers to acceptance of location-based services (LBS) in a community of older adults. Objective: to understand attitudes to LBS technologies in older adults. Methods: eighty-six older adults used LBS for 1-week and completed pre- and post-use questionnaires. Twenty available volunteers from the first study also completed in-depth interviews after their experience using the LBS technology. Results: the pre-use questionnaire identified perceptions of usefulness, individual privacy and visibility as predictive of intentions to use a location-tracking service. Post-use, perceived risk was the only factor to predict intention to use LBS. Interviews with participants revealed that LBS was primarily seen as an assistive technology and that issues of trust and privacy were important. Conclusion: the findings from this study suggest older adults struggle to see the benefits of LBS and have a number of privacy concerns likely to inhibit future uptake of location-tracking services and devices

Identity dynamics as a barrier to organizational change

This article seeks to explore the construction of group and professional identities in situations of organizational change. It considers empirical material drawn from a health demonstration project funded by the Scottish Executive Health Department, and uses insights from this project to discuss issues that arise from identity construction(s) and organizational change. In the course of the project studied here, a new organizational form was developed which involved a network arrangement with a voluntary sector organization and the employment of “lay-workers” in what had traditionally been a professional setting. Our analysis of the way actors made sense of their identities reveals that characterizations of both self and other became barriers to the change process. These identity dynamics were significant in determining the way people interpreted and responded to change within this project and which may relate to other change-oriented situations

A survey of canine filarial diseases of veterinary and public health significance in India

Background. Dirofilaria spp., Acanthocheilonema spp. and Brugia spp. have all been reported in Indian dogs. In previous studies, diagnosis was made by morphological identification only. This is the first geographically stratified cross-sectional study in India to determine the prevalence and geographical distribution of canine filarial species of veterinary and public health importance, using a combination of conventional and molecular diagnostic techniques. Results. A total of 139 from 525 dogs (26.5%; 95% CI 22.7, 30.3) were positive for microfilariae. The most common species of canine filaria identified in this study was A. reconditum (9.3%) followed by D. repens (6.7%) and D. immitis (1.5%). Three out of 525 dogs were found to have mixed infections on PCR. The morphological and molecular evidence on the sequence of the 18S gene and phylogenetic analysis of the ITS-2 region provided strong evidence that the canine microfilariae discovered in the Himalayan city of Ladakh belong to a novel species of Acanthocheilonema. Two dogs in Ladakh were also found to have mixed infections of the novel species described above and a unique microfilaria which morphologically resembled Microfilaria auquieri Foley, 1921. Conclusions. At least six species of filarial nematode are now known to infect dogs in India, two of which were reported for the first time in this study. The study also confirms and extends the geographical distribution of canine heartworm (D. immitis) which overlaps with D. repens, emphasising the importance for veterinary clinicians and diagnostic laboratories to utilise immunodiagnostic tests that will not cross-react between those two filarial species. From a public health viewpoint, the distribution and prevalences of these nematodes warrant an appropriate prophylaxis to be administered to dogs

Clinical implications of circulating tumor cells of breast cancer patients: role of epithelial-mesenchymal plasticity

There is increasing interest in circulating tumor cells (CTCs) due to their purported role in breast cancer metastasis, and their potential as a “liquid biopsy” tool in breast cancer diagnosis and management. There are, however, questions with regards to the reliability and consistency of CTC detection and to the relationship between CTCs and prognosis, which is limiting their clinical utility. There is increasing acceptance that the ability of CTCs to alter from an epithelial to mesenchymal phenotype plays an important role in determining the metastatic potential of these cells. This review examines the phenotypic and genetic variation, which has been reported within CTC populations. Importantly, we discuss how the detection and characterization of CTCs provides additional and often differing information from that obtained from the primary tumor, and how this may be utilized in determining prognosis and treatment options. It has been shown for example that hormone receptor status often differs between the primary tumor and CTCs, which may help to explain failure of endocrine treatment. We examine how CTC status may introduce alternative treatment options and also how they may be used to monitor treatment. Finally, we discuss the most interesting current clinical trials involving CTC analysis and note further research that is required before the breast cancer “liquid biopsy” can be realized

Research and Education in Computational Science and Engineering

Over the past two decades the field of computational science and engineering (CSE) has penetrated both basic and applied research in academia, industry, and laboratories to advance discovery, optimize systems, support decision-makers, and educate the scientific and engineering workforce. Informed by centuries of theory and experiment, CSE performs computational experiments to answer questions that neither theory nor experiment alone is equipped to answer. CSE provides scientists and engineers of all persuasions with algorithmic inventions and software systems that transcend disciplines and scales. Carried on a wave of digital technology, CSE brings the power of parallelism to bear on troves of data. Mathematics-based advanced computing has become a prevalent means of discovery and innovation in essentially all areas of science, engineering, technology, and society; and the CSE community is at the core of this transformation. However, a combination of disruptive developments---including the architectural complexity of extreme-scale computing, the data revolution that engulfs the planet, and the specialization required to follow the applications to new frontiers---is redefining the scope and reach of the CSE endeavor. This report describes the rapid expansion of CSE and the challenges to sustaining its bold advances. The report also presents strategies and directions for CSE research and education for the next decade.Comment: Major revision, to appear in SIAM Revie

Community peer-led falls prevention presentations: What do the experts suggest?

Falls among older adults are a major problem. Despite considerable progress in falls prevention research, older adults often show low motivation to engage in recommended preventive strategies. Peer-led falls prevention education for older adults may have potential for bridging the research evidence-practice gap, thereby promoting the uptake of falls prevention strategies. We evaluated peer educators’ presentations of falls prevention education to community-dwelling older adults in regard to established criteria that were consistent with adult learning principles, the framework of health behaviour change, falls prevention guidelines, and recommendations for providing falls prevention information. We conducted a within-stage mixed model study using purposive and snowball sampling techniques to recruit 10 experts to evaluate video recordings of the delivery of three peer-led falls prevention presentations. Each expert viewed three videos and rated them using a questionnaire containing both open-ended and closed items. There was a good level of expert agreement across the questionnaire domains. Though the experts rated some aspects of the presentations highly, they thought that the presentations were mainly didactic in delivery, not consistently personally relevant to the older adult audience, and did not encourage older adults to engage in the preventive strategies that were presented. Based on the experts’ findings, we developed five key themes and recommendations for the effective delivery of peer led falls prevention presentations. These included recommending that peer educators share falls prevention messages in a more interactive and experiential manner and that uptake of strategies should be facilitated by encouraging the older adults to develop a personalised action plan. Findings suggest that if peer-led falls prevention presentations capitalise on older adults’ capability, opportunity, and motivation, the older adults may be more receptive to take up falls prevention messages

Oral abstracts 1: SpondyloarthropathiesO1. Detecting axial spondyloarthritis amongst primary care back pain referrals

Background: Inflammatory back pain (IBP) is an early feature of ankylosing spondylitis (AS) and its detection offers the prospect of early diagnosis of AS. However, since back pain is very common but only a very small minority of back pain sufferers have ASpA or AS, screening of back pain sufferers for AS is problematic. In early disease radiographs are often normal so that fulfilment of diagnostic criteria for AS is impossible though a diagnosis of axial SpA can be made if MRI evidence of sacroiliitis is present. This pilot study was designed to indicate whether a cost-effective pick up rate for ASpA/early AS could be achieved by identifying adults with IBP stratified on the basis of age. Methods: Patients aged between 18 and 45 years who were referred to a hospital physiotherapy service with back pain of more than 3 months duration were assessed for IBP. All were asked to complete a questionnaire based on the Berlin IBP criteria. Those who fulfilled IBP criteria were also asked to complete a second short questionnaire enquiring about SpA comorbidities, to have a blood test for HLA-B27 and CRP level and to undergo an MRI scan of the sacroiliac joints. This was a limited scan, using STIR, diffusion-weighted, T1 and T2 sequences of the sacroiliac joints to minimize time in the scanner and cost. The study was funded by a research grant from Abbott Laboratories Ltd. Results: 50 sequential patients agreed to participate in the study and completed the IBP questionnaire. Of these 27 (54%) fulfilled criteria for IBP. Of these, 2 patients reported a history of an SpA comorbidity - 1 psoriasis; 1 ulcerative colitis - and 3 reported a family history of an SpA comorbidity - 2 psoriasis; 1 Crohn's disease. 4 were HLA-B27 positive, though results were not available for 7. Two patients had marginally raised CRP levels (6, 10 -NR ≤ 5). 19 agreed to undergo MRI scanning of the sacroiliac joints and lumbar spine; 4 scans were abnormal, showing evidence of bilateral sacroiliitis on STIR sequences. In all cases the changes met ASAS criteria but were limited. Of these 4 patients 3 were HLA-B27 positive but none gave a personal or family history of an SpA-associated comorbidity and all had normal CRP levels. Conclusions: This was a pilot study yielding only limited conclusions. However, it is clear that: Screening of patients referred for physiotherapy for IBP is straightforward, inexpensive and quick. It appears that IBP is more prevalent in young adults than overall population data suggest so that targeting this population may be efficient. IBP questionnaires could be administered routinely during a physiotherapy assessment. HLA-B27 testing in this group of patients with IBP is a suitable screening tool. The sacroiliac joint changes identified were mild and their prognostic significance is not yet clear so that the value of early screening needs further evaluation. Disclosure statement: C.H. received research funding for this study from Abbott. A.K. received research funding for this study, and speaker and consultancy fees, from Abbott. All other authors have declared no conflicts of interes