Education and training for people working with and caring for those with diabetes

The growing need for healthcare workers to be given education and training in diabetes care, along with the focus on improving self-management of the condition, prompted The Open University to launch 'Diabetes Care', a 20-week, first-level course, in 2005. The course was designed to meet the needs of lay people as well as those wishing to undertake a nationally accredited programme of study. It was immediately oversubscribed and continues to be extremely popular. The course model is being replicated in the design of two additional courses in preparation, 'Understanding Cardiovascular Diseases' and 'Managing Obesity'. – There is a substantial and growing demand for education and training in diabetes and its self-management, as evidenced by the ongoing popularity of the 'Diabetes Care' (SK120) course offered by The Open University – SK120 is a 20-week, entry-level course providing 15 CATS points that has been offered since September 2005 – It is based on a series of case studies presented via a DVD-ROM, a CD-ROM, a course book and online discussion forums – The model is being replicated in the preparation of two further courses focusing on cardiovascular diseases and the management of obesit

Multiple core hole formation by free-electron laser radiation in molecular nitrogen

We investigate the formation of multiple-core-hole states of molecular nitrogen interacting with a free-electron laser pulse. We obtain bound and continuum molecular orbitals in the single-center expansion scheme and use these orbitals to calculate photo-ionization and Auger decay rates. Using these rates, we compute the atomic ion yields generated in this interaction. We track the population of all states throughout this interaction and compute the proportion of the population which accesses different core-hole states. We also investigate the pulse parameters that favor the formation of these core-hole states for 525 eV and 1100 eV photons

The Internationalisation of Public Welfare Policy

With increasing globalisation of knowledge, there are increased opportunities to 'learn' from the experience ofpolicy interventions elsewhere. This paper presents evidence on the extent of international convergence inpublic policy, with particular focus on labour, welfare, savings and retirement policy. Questions addressed inthis framework include: to what extent is policy diffusion or convergence a real and relevant phenomenon?What role have economists played in the transfer of policy across national domains? Has policy transfer led to'better' public policy? Are there any practical limitations to policy convergence?welfare policy, internationalisation, globalisation, public policy, policy transfer, OECD

Role Of Digital Health Wearables In The Wellbeing And Quality Of Life Of Older People And Carers

The number of adults aged 65 and over has increased by 2% across Europe in the past 15 years, and in Northern Ireland by 22% between 2003-2013. The proportion of the population in this age group is projected to increase by 63% to just under 0.5 million by 2033 – which will be a quarter of the population in Northern Ireland. Given Northern Ireland’s Active Ageing Strategy (2015-2021), there is an increasing focus on encouraging physical activity as we get older to preserve mobility and motor skills, and to enjoy the benefits of living longer and to minimise health problems associated with ageing. Over the last two years, we have been investigating the role of wearable activity tracking technologies in self-monitoring of activity by people aged over 55. Example technologies include activity trackers from Fitbit, Garmin and Samsung, and smart watches. Typically, these devices record steps walked, sleep patterns, calories expended and heart rate. Based on empirical investigations, this policy paper describes the benefits of activity monitors for people aged over 55 for self-monitoring of physical activity, for adopting healthy lifestyles, and for increasing or maintaining physical activity as a way to avoid high blood pressure, obesity, diabetes, and other medical conditions associated with weight or lower physical activity. It outlines the role of activity trackers in post-operative monitoring of mobility during rehabilitation, in caring, and for possible use of the data for diagnosis and medical interventions. It then discusses the challenges for adoption of these technologies, given currently, off-the-shelf devices are designed and calibrated for use by physically fit (typically young active people) with unrealistic fitness targets for the older generation

Resolving Exceptional Configurations

In lattice QCD with Wilson fermions, exceptional configurations arise in the quenched approximation at small quark mass. The origin of these large previously uncontrolled lattice artifacts is identified. A simple well-defined procedure (MQA) is presented which removes the artifacts while preserving the correct continuum limit.Comment: Talk presented by E. Eichten at Lattice 97, Edinburgh(UK), July97. 6 pages, LaTeX, 1 table, 5 figure

Investigating the influence of wearable activity - tracking technologies on behaviour change in people aged 55 and over

Our research project (http://www.shaileyminocha.info/digital-health-wearables/) at UK’s Open University and in collaboration with Age UK Milton Keynes aims to investigate whether behaviour changes in people aged over 55 years through the use of wearable activity-tracking technologies. Example technologies include those from Fitbit, Jawbone, or smart watches from Apple or Samsung. Typically, these devices record steps walked, sleep patterns, or calories expended.    The benefits of regular physical activity for older adults and those with chronic disease and/or mobility limitations are indisputable. Regular physical activity attenuates many of the health risks associated with obesity, cardiovascular disease, diabetes, depression and anxiety, and cognitive decline. As physical activity levels among older adults (both with and without chronic disease) are low, facilitating an increase in activity levels is an important public health issue. Walking has been identified as an ideal means of low-impact, low-risk physical activity that can boost physical and mental wellbeing. An author of a recent study said: “Physical activity may create a ‘reserve’ that protects motor abilities against the effects of age-related brain damage”. Walking has been shown to improve cognitive performance in older people. Our previous research has shown that walking with others can help reduce social isolation and loneliness among people aged 55 and over. In our year-long project (May 2016 – April 2017) and funded by the Sir Halley Stewart Trust, we have given activity-trackers to 17 participants in the age range from 55 – 80. Through monthly workshops, diaries that the participants are maintaining and sharing with us on a weekly basis, and through one-to-one interviews with them, we are investigating how the behaviours of our participants is changing – whether there is an increase in their activity such as walking or gardening, lifestyle changes, attitudes towards food/diet, and so on. There is already some evidence emerging such as: increase in activity levels in all the participants; increased awareness of food intake; and sharing of data with the GPs to diagnose the non-optimal sleep patterns (one of them now has a treatment plan in place for poor sleep). A couple of participants have joined the gym when they realised that their desk-based work-life doesn’t give them the opportunity to stay active during the week. In addition, we have conducted two surveys: the first survey is aimed at people aged 55 years and over who are already using these devices - to investigate their experiences and the changes in their behaviours that they perceive; and the second survey is aimed at medical professionals to explore whether they use the data from these devices for diagnosis and intervention. Most importantly, do medical professionals use data from these devices to determine the behaviour or lifestyle changes in people aged over 55 years? The Open University's Human Research Ethics Committee has approved the research design of this project (HREC/2016/2191/Minocha/1)

Minimal Patients’ Clinical Variables to Accurately Predict Stress Echocardiography Outcome: Validation Study Using Machine Learning Techniques

Background: Stress echocardiography (SE) is a well-established diagnostic tool in assessing patients with suspected coronary artery disease (CAD). Cardiovascular risk factors are used in the assessment of the probability of CAD. The link between the outcome of SE and patients’ variables including cardiovascular risk factors, current medication and anthropometric variables has not been widely investigated. Objective: This study aims to use Machine Learning (ML) to predict significant CAD defined by positive SE results in patients with chest pain based on patients’ anthropometrics, cardiovascular risk factors and medication as variables. Methods: A ML framework is proposed to automate the prediction of SE results. The proposed framework consists of four stages; feature extraction, pre-processing, feature selection and classification stage. A mutual information-based feature selection method was used to investigate the amount of information that each feature carries to define the positive outcome of SE. Two classification algorithms, Support Vector Machine (SVM) with Radial Basis Function (RBF) kernel, and Random Forest classifiers have been deployed. Data from 529 patients have been used to train and validate the proposed framework. Their mean age was 61 (±12 SD). The data consists of the anthropological data and cardiovascular risk factors such as gender, age, weight, family history, diabetes, smoking history, hypertension, hypercholesterolaemia, prior diagnosis of CAD and prescribed medications at the time of the test. The results of the SE were defined as outcome. A total of 82 patients had positive (abnormal) and 447 negative (normal) results, respectively. The proposed framework has been evaluated using the whole dataset including the cases with prior diagnosis of CAD. Five folds cross validation was used to validate the performance of the proposed framework. We also investigated the model in the subset of patients with no prior CAD. Results: The feature selection methods showed that prior diagnosis of CAD, sex, and prescribed medications such as angiotensin convertase enzyme inhibitor or angiotensin receptor blocker were the features that shared the most information about the outcome of SE. SVM classifiers showed the best trade-off between sensitivity and specificity and was achieved with three features. The best trade-off between sensitivity and specificity for the whole dataset accuracy was 66.63% with sensitivity and specificity 72.87%, and 67.67% respectively. However, for patients with no prior diagnosis of CAD only two features (sex and angiotensin convertase enzyme inhibitor or angiotensin receptor blocker use) were needed to achieve accuracy of 70.32% with sensitivity and specificity at 70.24%. Conclusions: This pilot study shows that ML can predict the outcome of SE in detecting significant CAD based on only a few features: patient prior cardiac history, gender, and prescribed medication. Further research recruiting higher number of patients who underwent SE could further improve the performance of the proposed algorithm with the potential of facilitating patient’s selection for early treatment / intervention with avoiding un-necessary downstream testing

Social isolation and loneliness in people aged 55 and over in the UK

In association with Age UK Milton Keynes, we have conducted research to investigate the conditions that lead to social isolation and loneliness among older people (55 years and above) in Milton Keynes, and to recommend possible strategies and solutions to prevent and mitigate isolation. The project was funded by the Milton Keynes Council and commissioned by the Senior Joint Commissioner, Adult Community Services. The research has involved a review of academic and policy literature on social isolation and loneliness, and an information gathering exercise that included expert workshops, individual and group interviews, and site visits. This talk will be based on the project's report (http://oro.open.ac.uk/43925/) and will discuss several case studies of older people and interventions for social isolation and loneliness within Milton Keynes. We hope that the recommendations and the resources from our report and in this talk would be useful for other communities, towns and cities, who may also be facing the challenges of supporting an ageing population. Taking the example of an online photo journal which encourages users to document their life with just one photo each day, we will discuss how online social interactions influence the lives of older people, the challenges that they face, and the concerns that they have about being online

Social isolation and loneliness in people aged 55 and over in Milton Keynes: the way forward

The Ageing Well and Living Well Scoping Workshop was organised by Gail Addison, Head of Public Health – Delivery, People Directorate, Milton Keynes Council in collaboration with Age UK Milton Keynes. The aims of the workshop were to: • Explore the connectivity between the Health and Wellbeing Board (HWB) and existing Partnership and Programme Boards across Milton Keynes • Explore the remit of the Partnership and Programme Boards in order to identify commonalities and fit with the HWB Board’s Strategic Implementation Plan and Priorities, including; • Social Isolation (Priority focus for Ageing Well partnership) • Reducing Obesity (Priority focus for Living Well partnership) • Identify next steps and commitment to action At this workshop, Professor Shailey Minocha of The Open University along with Jane Palmer, CEO, Age UK Milton Keynes led the track on social isolation and loneliness in people aged over 55 years in Milton Keynes. We highlighted the effects of social isolation and loneliness on the well-being and quality of life of people. For example, individuals lacking social contact carry a health risk equivalent to smoking up to 15 cigarettes in a day. We discussed the societal impacts of social isolation such as increased use of health and social care services, higher number of emergency admissions and GP consultations, slower discharge from hospitals which causes pressure on financial resources and health services. We outlined the risk factors of social isolation and particularly in the context of Milton Keynes. Drawing on from our report (http://oro.open.ac.uk/43925/), we emphasised the challenges for the community and for older people due to the increasing population of older people in Milton Keynes. We presented possible solutions for addressing the problem of social isolation and loneliness in Milton Keynes in three categories: one-to-one interventions (e.g. visits by community home visitors, regular phone conversations, visits by neighbours); group interventions (e.g. Men in sheds, lunch clubs, coffee mornings, inter-generational initiatives – for example, learning to get online, walking groups, local history society) and wider community and neighbourhood interventions such as encouraging older people to be volunteers; co-designing the programmes with older people - e.g. neighbouhood watch programmes and design of age-friendly design of spaces – local neighbourhoods and city centre in Milton Keynes

Social isolation and loneliness in people aged 55 and over in Milton Keynes: developing an action plan

In this workshop, we outlined the conditions that lead to social isolation and loneliness among older people (55 years and above) in Milton Keynes, and recommended possible strategies and solutions to prevent and mitigate isolation. The findings are based on the Milton Keynes Council-commissioned report http://oro.open.ac.uk/43925/. The research involved a review of academic and policy literature on social isolation and loneliness, and an information gathering exercise that included expert workshops, individual and group interviews, and site visits. The general risk factors that affect Milton Keynes residents include: low income, low literacy, poor health and disability, losses and bereavement, family, social and neighbourhood change, unemployment or redundancy, and aspects of the built environment and infrastructure. Specific additional challenges for Milton Keynes include: rapidly ageing population (from a low base); the pace of development of Milton Keynes and neighbourhood changes; structural elements including the design of and balance between the city centre, housing estates, and satellite villages; community diversity from deprived to affluent areas; a diverse and growing population of older people from Black, Asian, Minority Ethnic (BAME) groups; and the crucial on-going transport issues. We discussed services to alleviate social isolation and which cater to different kinds of needs, including one-to-one services (e.g. visits by community home visitors, regular phone conversations, walking ‘partner’ – e.g. after the bereavement of a pet), group services (e.g. lunch clubs, coffee mornings, Men in sheds, knitting club, walking groups, local history society), and wider social activities (e.g. capturing sporting memories or reminiscing). We identified a need for continuity of several of these services, and that new services should be developed to bridge gaps in provision. We recommended that Milton Keynes Council should consider: paying attention to events in the lives of older people, designing a variety of services for different age groups, life stages and health (55+, 65+, 75+, 85+, …), inter-generational initiatives, being gender-aware, focussing on the quality rather than the quantity and recognising that families play a key role. We suggested factors for successful service design: developing services that are co-designed and led by older people, council-provided framework for delivery of the services (e.g. ‘neighbourhood watch’ in West Bletchley), developing volunteering capacity within communities and training for the volunteers (e.g. by Age UK Milton Keynes). Further, we suggested that it is important to know the social and economic impact of the service and, therefore, evaluation should be integral when the service is being designed and delivered. We emphasised that there is a need for a ‘simple’ and low cost evaluation toolkit: e.g. well-being questionnaire or workshops to determine the reach and impact of the service. This evaluation will feed into the improvement of the service and possibly more funding to grow and sustain the service. We listed three key messages from our research: co-designing services with older people that match with their requirements; evaluation should be integral when the service is being designed and delivered and imparting digital skills to people aged over 55 years (http://oro.open.ac.uk/44009/) which would influence and possibly improve their interactions with the local government, help in cultivation of their interests, and facilitate social interactions