Buckley trail

Visiting Buckley this weekend and went for a couple of jogs along the Buckley Heritage Trail.

It's a pretty route through some of Buckley's old brickworks. There is a bit of commissioned art along the way.

Was about 7km jog from Manor Drive and around the trail. Helped that it was sunny and warm, even at 6.30am.

Location:Westbrook Dr,Buckley,United Kingdom

Running into a lamp-post

Went for a run this morning. Into a lamp-post. Tip of the day. Dont try running with your eyes closed.

Location:Manor Dr,Buckley,United Kingdom

UPDATE: And here is the lamp-post.

And one of both me, and the lamp-post.

Big socks

I dont know where these came from. But found myself wearing them yesterday.

Location:Meg's Ln,Buckley,United Kingdom

Lunch at Snugburys

Popped in to http://www.snugburys.co.uk/ for an Ice Cream.

Look who else was taking a milk based treat.

Merrily We Roll Along

26 May 2012
Theatre Clwyd
Seats J9 and J8
£19.50








This is what The Stage thought:

Tackling the digital divide. Should we compel, educate, or nudge people online?

The use of behavioural economics in the context of policy for older people has been high on our agenda over the past year. ILC-UK has explored the potential for behavioural economics to increase pension saving. We have also looked to how these theories can help support older people to make the right decisions about when to stop driving. And we have considered the potential for using behavioural theories to encourage people to make the right health decisions.

Over the next few months (kindly supported by the Nominet Trust) we will be exploring the role of behavioural economics in relation to the continuing digital exclusion faced by many older people.

The latest (November 2011) Internet Access Quarterly Update [1] highlights the scale of the challenge ahead. By the third quarter of 2011, 8.43 million adults had never used the Internet. While 98.6% of 16 to 24 are Internet users, just 27% of those aged over 75 have ever used the internet.
And whilst many highlight increases in online activities by older people, progress is actually very slow. Between the first and third quarter of 2011, the percentage of 65 to 74 year olds who have ever used the internet grew from just 57.1% to 58.7%. This growth amounted to just under 40,000 fewer people in this age group who had never used the internet.

We learnt more about internet usage and age in the ONS report, Internet Access – Households and Individuals [2], published in late August last year.
The statistics revealed that:
• Older people haven’t caught the social networking bug. Whilst it is a popular activity for 91% of 16 to 24 year old internet users, only 18% of over 65s participated in social networking.
• 5.7 million households have no internet access
• We have seen significant growth in mobile internet access which may be creating a new digital divide. 71% of 16-24 year olds use mobile internet compared with just 8% of those aged 65 plus.
• There remains a significant gender gap in internet use. Men aged over 75 are almost twice as likely to have ever used the internet as women of same age (21.6% cf 35.2%)

Our piece of work will attempt to take a new approach to explore what we can do to get people online. Put simply, should we compel, educate, or nudge people online?

We know that 32 million people (66% adults) have purchased goods over the internet. But we seem to buy different things online as we age. The most popular internet purchases for over 65s are travel related. Perhaps this emphasises the importance of compulsion. Buying travel tickets can be very difficult if you don’t do it online.

At the same time, older people are more likely than other ages to confess to lacking skills. Those aged over 65 are twice as likely than 16-24 year olds (29% compared with 15%) to claim they don’t have the skills to protect personal data online. 23% of those aged 65 plus claim their computer skills are not proficient to protect themselves from viruses (compared with 14% of 16 to 24 year olds). So perhaps the key remains in education. But if so, how can we deliver it in a cost-effective way when funding for adult learning is thinly stretched?

Or are there other approaches we can learn from behavioural economics. Can we find new and innovative ways to nudge people online?

Our view is that this shouldn’t be an issue we ignore. So should we force, educate or nudge people online? What do you think?

David Sinclair

[1] Internet Access Quarterly – Office of National Statistics
http://www.ons.gov.uk/ons/rel/rdit2/internet-access-quarterly-update/2011-q3/art-internet-access-q3.html
[2] Internet Access – Households and Individuals, 2011
http://www.ons.gov.uk/ons/rel/rdit2/internet-access—households-and-individuals/2011/stb-internet-access-2011.html

My recent presentation on centenarians is now online.

ILC-UK/Actuarial Profession Robert Butler Memorial Lecture, in partnership with Age UK and JRF - David Sinclair

View more presentations from ILC- UK

Technology works (“if delivered properly”)

Posted on December 15, 2011 at www.ilcuk.org.uk

Telecare and telemedicine can improve health outcomes and save money, argued the Prime Minister last week.[1]

The Whole System Demonstrator (WSD) programme was set up by the Department of Health to attempt to, amongst other things, explore the evidence base as to the effectiveness and cost-effectiveness of these technologies. This week the Department of Health (DH) published the headline findings from the WSD.[2]

The findings are striking. “If delivered properly, telehealth can substantially reduce mortality, reduce the need for admissions to hospital, lower the number of bed days spent in hospital and reduce the time spent in A&E” argued the DH.

The randomised control trial of over 6000 patients found that if delivered properly telehealth can deliver:
• 15% reduction in A&E visits,
• 20% reduction in emergency admissions
• 14% reduction in bed days
• 8% reduction in tariff costs
• 45% reduction in bed days

Now this won’t be news to many. Many have made similar claims of effectiveness before (Companies selling these technologies, Government, local authorities, voluntary sector), but having this new data is very good news. There should however be a real note of caution. The short paper implies more questions than answers. The “if delivered properly” caveat needs to have been explained. Sadly the three page report feels too much like it was rushed out in order to give the Prime Minister something to announce.

Our report on Centenarians [3] published at the end of November highlighted a very interesting piece of research from Cambridge. “60% of interviewees aged over 90 had had a fall and that of these, four in five were unable to get up after at least one fall and almost a third had lain on the ground for an hour or more.” Yet in these cases, call alarms were widely available but not used [4]; a good example of technology not being delivered properly.

Even if there is a convincing case that technology, “if delivered properly”, can save money and improve health outcomes, we probably need to know more about how much it may cost and how possible it will be to “deliver properly”.

The Whole System Demonstrator seems to be revealing good news. But in a time of fiscal austerity and an ageing population, will commissioners have the resources to properly invest not just technology, but also the support package needed to ensure that the financial and health outcomes are maximised?

David Sinclair
1. http://www.guardian.co.uk/healthcare-network/2011/dec/07/telehealth-funded-life-sciences-strategy
2.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_131684 3. Living Beyond 100 is available at: http://www.ilcuk.org.uk/index.php/publications/publication_details/living_beyond_100_a_report_on_centenarians 4. Fleming and Brayne, 2008; Cambridge City over 75-Cohort. BMJ

Are we becoming complacent about immunisaton

Posted at www.ilcuk.org.uk on November 16, 2011

Front page news in today’s Brighton Argus makes very worrying if depressingly predictable reading (Measles Sweeps Through Brighton and Hove (1)). The newspaper reports that “Nine children at two Hove schools have been diagnosed with the potentially fatal infectious disease in the past couple of weeks – more than the entire number of cases in the whole of Sussex last year.” It goes on to point out that some babies too young to be vaccinated have contracted the condition from other children.

What this issue isn’t however, is a just local problem for the people of Brighton. France has seen a very severe outbreak this year and a quick “google news” search highlights measles outbreaks in Canada, the United States (2), and New Zealand.

Just last week, the European Centre for Disease Prevention and Control (ECDC), highlighted “worrying signals” on epidemics of measles. Marc Sprenger, ECDC director argued that “The biggest threat we face is complacency about infectious diseases. The attitude that the battle against infectious diseases has been won must be continuously challenged,” (3)

In Brighton, authorities are responding by vaccinating children in schools. This is of course vital. Earlier this year the Health Protection Agency (HPA) urged parents to ensure that their children were vaccinated after a “tenfold increase in measles cases in the first four months of the year” (4)

It is easy to say after the event that children should have been vaccinated earlier. But what this outbreak does highlight is that despite warnings from the HPA, we may have taken our eye of the ball.

Over the last few years, ILC-UK has been studying and developing the case for adult immunisation. Through the ILC global alliance we have published reports (5) on the case for a life-course approach to vaccination. ILC-UK has developed thinking on how we could better deliver the flu vaccination to adults (6). ILC-UK also presented our thoughts on adult immunisation at European Health Forum Gastein earlier this year. (7) (8)

So, how does the measles outbreak among children fit in with our concerns about adult immunisation? At one level, it is important to note that measles occurs in adulthood as well as in children. It is also worth mentioning the importance of herd immunity (9).

But there are much bigger issues at play here and they are extremely worrying. The reality, as highlighted by ECDC, is that perhaps we are becoming complacent about immunisation.

Vaccination has a very positive story to tell, having controlled 12 major diseases (in many parts of the world). Other than clean water, it has probably had the biggest impact on mortality reduction and population growth.

Historically, we have “done” child immunisation very well in the UK. But we must ensure that as a result complacency doesn’t undermine progress. And we need to work across all vaccine preventable diseases to ensure that we not only continue to do child immunisation well, but that we improve it.

Alongside this, we must improve the way we deliver vaccination across the lifecourse. When the HPA made their warnings in May, their spokesperson, Dr Mary Ramsay, said “You’re never too old to get vaccinated” (4). Let’s hope we can find a way to better get this message out.

David Sinclair

1.http://www.theargus.co.uk/news/9366632.Measles_sweeps_through_Brighton_and_Hove/
2.There have been 220 cases of measles in the United States this year, the most since 1996 http://pediatrics.about.com/b/2011/11/13/dismay-at-measles-outbreaks.htm
3.http://ecdc.europa.eu/en/publications/Publications/1111_SUR_Annual_Epidemiological_Report_on_Communicable_Diseases_in_Europe.pdf
4.http://www.bbc.co.uk/news/health-13561766
5.See: http://www.ilc-alliance.org/book/life-course-vaccination-impact-life-course-vaccination-ageing-population.html and http://www.ilc-alliance.org/book/immunisation-not-just-kids.html
6.http://www.ilcuk.org.uk/files/pdf_pdf_190.pdf
7.Our slides from the European Health Forum Gastein can be found at http://www.slideshare.net/ILC-UK/optimising-adult-vaccination-in-europe
8.ILC-UK receives some (unrestricted) support from Amgen, Sanofi Pasteur MSD and Pfizer
9.http://en.wikipedia.org/wiki/Herd_immunity

Optimising Adult Vaccination in Europe

My presentation at Gastein in October 2011:

Optimising Adult Vaccination in Europe

View more presentations from ILC- UK.