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2012 Edition boosted by
INNO4AGEING is a XISCAT Network event
Supported by
INNO4AGEING
The international meeting point
of Active Ageing in Catalonia
2012 Edition boosted by
INNO4AGEING is a XISCAT Network event
Supported by
INNO4AGEING IS A TWO-DAY CONGRES RECOGNIZED AS EU INITIATIVE SUPPORTING THE
EUROPEAN YEAR FOR ACTIVE AGEING AND SOLIDARITY BETWEEN GENERATIONS
With a strong focus on improving senior's health and wellbeing through the analysis, debates
and scientific and business networking based on innovations in Hospitals activity, it highlights
cutting-edge technology and results on Ambient Assisted Living (AAL), Chronicity, Telemedicine,
Rehabilitation, and Information and Communications Technology (ICT) in Health.
INNO4AGEING IS A XISCAT NETWORK EVENT IMPULSING THE INTERNATIONALITY OF THE
INNOVATION BASED ON MEDICAL ACTIVITY FOR CATALAN TERRITORY
Located at Vilanova i la Geltrú, hosted by Fundació ABAT (XISCAT member at Garraf) and co-
organized together with Parc de Salut (Catalan Innovation Hub on medical devices and health).
Learn more about it on www.parcdesalut.com/ageing
2012 Edition boosted by
INNO4AGEING is a XISCAT Network event
Supported by
HIGH-VALUE ON INNOVATION AT AGEING TAKE-CARE AND TREATMENTS ON GARRAF
2012 Edition boosted by
INNO4AGEING is a XISCAT Network event
Supported by
XISCAT, the largest national
Hospital, Medical & Socio-
sanitary Centers Network
working on R+D+i
www.parcdesalut.com/xiscat
is proud to introduce
the INNO4AGEING poster
compilation
INNO4AGEING is a XISCAT Network event
2012 Edition boosted by Supported by
1. Mechatronics based rehabilitation at home
2. The educational & training needs of a group of careers of elderly people in Osona
3. Nutritional intake & cognitive status in nursing
4. The experience of functional autonomy loss in elderly people: The disregarded voices
5. Decision support system (DDS) for risk assessment in low impact femoral fractures
6. Portable and adaptable BELT
7. Neurosciences Research Cluster of Excellence
8. NeuroRescue
9. VTT Active Ageing Forum
10. i-salut a casa
11. Leading innovative Health Solutions: pectus UP Surgery Kit
12. HELP: Home-based Empowered Living for Parkinson’s disease patients
13. eCAALYX. Enhanced Complete Ambient Assisted Living Experiment
SUMMARY
May 1st
2010 - October 31st
2011
Mechatronics based Rehabilitation at Home
Lead Participant
Fontys University of Applied Sciences (School of
Engineering, Mechatronics Department) - North Brabant
(NL) Contact: Mr. Johan Vlugter (j.vlugter@fontys.nl)
Participants
Technical University of Catalonia-Industrial Equipment
Design Center (CDEI-UPC) - Catalonia (ES)
University of Brescia (Laboratory of Mechatronics, Faculty
of Engineering) - Lombardy (IT)
University of West Bohemia (Faculty of Applied Sciences,
Department of Cybernetics) - South West Bohemia (CZ)
Upper Austria University of Applied Sciences Research &
Development - Upper Austria (AT)
Companies & Institutions
FOCAL Meditech B.V. - North Brabant (NL)
Fitland - North Brabant (NL)
Zuidzorg Foundation - North Brabant (NL)
Privamed Inc. - South West Bohemia (CZ)
Project data
Duration 18 months,
(May 1st 2010 - October 31st 2011)
Budget: € 458.384,-
ERDF funding € 369.551,30
Website www.mrh-project.eu
About Innovation 4 Welfare
Across Europe economic and demographic development
pose new challenges in health related issues: a general
tendency to prioritize on health and safety, the strong
increase in welfare-related diseases and the increased
need for (home) care for the ageing population, are
causing health care costs to increase rapidly. Innovative
solutions are necessary to meet these challenges and to
avoid health care becoming unaffordable.
Changing health needs are also an opportunity. It is an
attractive target area for developing innovative new
technologies and applications. Innovation 4 Welfare
aims to stimulate the development of health related
innovations. It is a four year mini-programme co-funded
by the European Regional Development Fund
(Interreg IVC) and has six partners throughout Europe.
These partner regions exchange good practices, execute
new innovation projects and try to influence regional
policies by stimulating innovation in the field of health
and safety. ( www.innovation4welfare.eu)
Partner regions
Innovation 4 Welfare involves partners from six regions
across Europe
Catalonia - Spain ACC1Ó
Lombardy - Italy CESTEC
Upper Austria - Austria TMG
Tartu - Estonia Tartu Science Park
South West Bohemia - Czech Republic RERA
Addressed needs
Against the background of increasing numbers of elderly
people living longer (double ageing) and growing impor-
tance of chronic diseases like diabetes (welfare diseases),
continuing the increase of quality, access and efficiency of
healthcare is considered one of the largest challenges in all
Regions of the European Community.
There is a clear understanding that better healthcare
and quality of life in general can be achieved for people
suffering from chronic diseases or disabilities through
technological innovation initiated in particular by SME’s.
Increasing numbers of (elderly) people need long term
rehabilitation due to some disease or trauma. With
execution of this project the participants aim to address
societal, economical, medical and technological needs
and challenges connected to the increasing demand of a
high quality and high volume of affordable rehabilitation
Mechatronics based
Turning welfare challenges into business opportunities
North Brabant - the Netherlands Province of North Brabant
services to elderly and/or chronically ill people.
Today therapy is offered to a patient by a therapist (usually
one on one) in healthcare centres or at the patient’s
private home.
the years, travelling to a health centre will often be
difficult, time consuming and expensive.
of home bound patients will inevitably increase
making the future of therapy at home on a ‘one on
one’ basis an almost unsustainable service.
a considerable impact on the daily routine of the
patient, as planning is and will be mainly based on the
schedules of the relative decreasing number therapists
available.
Activities for physiotherapy can be very roughly divided
into:
a body part and the therapist or a mechanical device
counteracts it. With equipment available at healthcare
centres a limited number of these treatments can be
executed autonomously. The equipment commercially
available to therapists today is still basically of mecha-
nical nature, with some added electronic (recording)
functionalities. More complex exercises are performed
manually by the therapist on the patient.
(moves the body part) and the patient should to some
extend and ability counteract the imposed movement.
In general this type of exercises is fully manually
applied ‘one on one’ to the patient by the therapist.
Rehabilitation treatments must be performed in many
cases with considerable accuracy over longer periods
of time to be effective and are therefore strenuous,
labour intensive and expensive. Overall effectiveness and
efficiency of therapy today still depends almost solely on
the (manual) skills and experience of the therapist.
There is an eminent need to address the growing
demand of rehabilitation services, for the European
Regions to be able to sustain in future years at least an
acceptable but preferably an enhanced level of these
services for the elderly and /or chronically ill people.
Approach
The basic approach of this project is to investigate the
increase of overall quality, efficiency and effectiveness of
physiotherapy to be achievable by introducing mechat-
ronics based rehabilitation equipment designed for the
use by patients at home under (remote) supervision by
therapists and medical specialists and thus reducing the
number of repetitive visits to or from therapists.
Main activities
The MRH project will focus on five main issues:
1. The present developments in rehabilitation
2. The success factors of a MRH application
3. The business opportunities for a MRH application
4. The design and development of MRH applications
5. The steps to be taken to make MRH applications
a success
At least five pilot applications will be developed to
demonstrate the results of the studies. The results will be
presented and discussed at five international meetings.
The overall results will be used to compose a ‘white book’
on the MRH concept.
Output
The MRH subproject aims to develop a ‘white book’ on
the different aspects of rehabilitation at home based on
Mechatronics. Input for this white book will be obtained
by consultation and by own research, and will be made
available for regional policymakers, companies and
authorities providing health and social care.
Rehabilitation at Home
Turning welfare challenges into business opportunities
Subproject participants
Mechatronics based Rehabilitation at Home
Catalonia
Technical University of Catalonia
Universitat Politècnica Catalunya (UPC)
Centre de Disseny d’Equipaments Industrials (CDEI)
Llorens Artigues 4-6, Edif U Planta O
08028 Barcelona, Spain
Contact: Sònia Llorens i Cervera Ilorens@cdei.upc.edu
Website: www.cdei.upc.edu/index-en.php
Lombardy
University of Brescia
Università degli Studi di Brescia (Unibs)
Piazza del Mercato, 15
25121 Brescia, Italy
Contact: Antonio Visioli antonio.visioli@ing.unibs.it
Website: http://www.unibs.it/on-line/ateneo/Home.html
North-Brabant (SLP)
Fontys University of Applied Sciences
Fontys Hogescholen (Fontys)
Rachelsmolen 1
5612 MA Eindhoven, The Netherlands
Contact: Johan Vlugter J.Vlugter@fontys.nl
Website: www.fontys.edu
South West Bohemia
University of West Bohemia
Západočeská univerzita v Plzni
Univerzitni 8
306 14 Plzeň, Czech Republic
Contact: Jaroslav Sobota jsobota@kky.zcu.cz
Website: http://www.zcu.cz/en/
Upper Austria
Upper Austria University of Applied Sciences
Fachhochschule Oberöstereich (FHOO)
Granisonstraße 21
4020 Linz, Austria
Contact: Andreas Schrempf andreas.schrempf@fh-linz.at
Website: http://www.fh-ooe.at/
The educational and training needs of a group of carers of elderly people in Osona
Vall Mayans, M.*
*Departament Salut i Acció Social
Facultat de Ciències de la Salut i el Benestar (FCSB)- UNIVERSITAT DE VIC (Barcelona)
OBJECTIVES
- To describe the functions of the carers of institutionalised elderly people
- To develop and validate an instrument to analyse the tasks performed by the carers
- To draw conclusions about the training needs of the Study Group (SG) and develop
a training proposal
Design: qualitative and descriptive study or diagnostic evaluation based on an analysis of the tasks
performed by the SG: information obtained from in-depth interviews, Residential Care Home records, field
observations based on a protocol and a checklist, fieldwork diary and documentary material.
Study period: 2009-2011.
Subjects and area studied: carers of the elderly in a formal setting; immigrant workers of varying age,
status, socioeconomic status, gender, and level of training/education, etc.; staff without managerial
responsibilities in privately owned or 3rd sector Residential Care Homes that are partly funded by the
Generalitat de Catalunya; in Osona.
..
RESULTS
CONCLUSIONS
MATERIAL AND METHODS
View of the managers of the Residential
Care Homes:
Participants: 9 (64.3%) / 14 (100%)
1st interview: the carers have training needs
2nd interview: validated the classification of tasks and
make suggestions regarding the training of the SG
SG Interview:
Profile
Participants: 44 (100%)→ women (89%)
aged between 19 and 56 (20-49)
arrived in Spain between 1971 and 2008
without Spanish nationality, but with a Residence Permit (80%)
educated to secondary level
with little experience of caring for the elderly before starting their current job
The SG feel they need training in: (approx. %)
PERSONAL HYGIENE ___________ 32%
ROOM TIDYING ___________ 32%
TOILETING ________________ 86.5%
NUTRITION AND FEEDING ________________ 59%
PUTTING TO BED ________________ 29.5%
RECORD KEEPING ___________ 91%
MOVING THE ELDERLY PERSON _________ 41%
NURSING CARE __________________ 86.4%
PERSONAL RELATIONS ___________ 70.5%
MEDICATION ___________ 70.5%
CLEANING/IRONING/OTHER TASKS ______ 15.9%
MEETINGS ___________ 43.2%
ONGOING IN-HOUSE TRAINING __________ 93.2%
OTHER ________________ 59.1%
Interviews
Observations
0
2
4
6
8
10
12
Numberofimmigrant
carers
Countries
Country of origin of SG
Direct observation of the SG:
N = 6 (2 mornings + 2 afternoons + 2 nights, ≠ Homes →
sample of approx. 13.5%), for 6–11½ hours (= length of
shift)
tasks performed: 132 / 220 (60% approx.), mainly
priority and secondary
time and staff are confirmed as insufficient to
perform all the validated tasks
many aspects of the work could be improved
Triangulation
The quality of the work of the
SG needs to be improved by
the suggested training
0
5
10
15
20
Centelles Manlleu SantQuirze
de Besora
Taradell Tona Torelló Roda de
Ter
Numberofimmigrant
carers
Towns
Location of Homes and SG
the capacities and skills the immigrant carers have are sufficient to cover some of the needs of the elderly residents
the carers feel they need to learn: to do some tasks, to improve others and to extend their skills, even in areas outside their professional responsibilities
to facilitate the learning of the SG, it is proposed that a training programme should be developed, using methods appropriate for adult learners who have
some experience, once their specific educational and training needs have been evaluated
UNIVERSITAT DE VIC
Nutritional intake and cognitive status in nursing home residents
MARÍA ESPERANZA DUDET CALVO
esperanza.dudet@uvic.cat
Department of Health and Social Action
Faculty of Health Sciences and Welfare – University of Vic (Barcelona)
Introduction: Malnutrition is a common problem in nursing homes,
and an inadequate nutrition can contribute to cognitive impairment.
The aim of this study was to determine the nutritional intake profile of
nursing home residents, related to cognitive status.
Methodology: A cross-sectional study was performed in 36 elderly (10
men and 26 women) institutionalized in a nursing home. Cognitive
status was determined using the Mini Mental State Examination
(MMSE), nutritional status whit the Mini Nutritional Assessment (MNA),
and nutritional intake using double weight dietary record for three days.
Results: All residents showed excessive intake of saturated fatty acids
and deficient in energy, carbohydrates, -linolenic acid,
docosahexaenoic acid, fibre, riboflavin, niacin, folic acid, vitamins B6, D
and E, calcium, magnesium, iron, zinc, iodine, sodium and copper.
Cognitively normal elderly showed better scores in Mini Mental State
Examination (21.7 ± 4.7 vs 16.8 ± 5.2, p = 0.037), and higher intake of
total fatty acids (36.0 4.0 vs 31.3 5.0, p = 0. 54; 36.0 4.0 vs 34.8
3.7, p = 0.094), monounsaturated fatty acids (14.0 ± 2.1 vs 11.3 ±
2.7, p = 0.042), polyunsaturated fatty acids (5.2 ± 1.2 vs 3.8 ± 1.1, p =
0.058), fibre (14.2 ± 4.5 vs 7.6 ± 4.2, p = 0.005), folic acid (173.6 ±
51.6 vs 101.2 ± 41.5, p = 0.013), vitamin C (116.5 ± 60.0 vs 89.2 ±
47.2 vs 66.8 ± 39.4, p = 0.051), vitamin E (3.7 ± 1.3 vs 2.4 ± 1.4, p =
0.065), iodine (67.7 ± 12.7 vs 48.1 ± 20.5, p = 0.067) and copper
(926.5 ± 409.9 vs 783.6 ± 623.7 vs 499.8 ± 256.2, p = 0.044) that
cognitive impaired elderly.
Conclusions: A higher intake of total fatty acids, monounsaturated
and polyunsaturated fatty acids, fibre, folic acid, vitamins C and E,
iodine and copper could contribute to better cognitive function. All
residents, regardless of their cognitive status, conducted a nutritionally
unbalanced and deficient diet.
Key words: nutritional intake, nutritional status, cognitive status,
nursing home elderly.
Abstract
Introduction
One of the health policy from WHO to promote active aging is to reduce the risk
factors related to the causes of major diseases, and to increase factors that
protect health; nutrition / feeding is one of the factors to address.
Malnutrition is a common health problem in nursing homes. Cognitive
impairment / dementia is one of the features that characterize the profile of
institutionalized elderly in these centres. Cognitive decline may be attributable,
in part, to inadequate nutrition. Considering all these factors, we carried out
this study in order to know the nutritional intake profile of nursing home
residents, based on cognitive status.
Results
Table 1. Baseline characteristics of study sample based on cognitive status.
(CIND: cognitive impairment no dementia; MNA: Mini Nutritional Assessment; MMSE: Mini Mental State Examination).
(1) Satisfactory nutritional status: 24 points; Risk of malnutrition: 17 – 23.5 points; Malnutrition: < 17 points.
(2) Normality vs CIND p = 0.000; Normality vs Dementia p = 0.000; CIND vs Dementia p = 0.035.
Table 2. Energy and nutrients intake based on cognitive status.
Normality
(n = 8)
CIND
(n = 12)
Dementia
(n = 16)
p Reference values
Age (years) 89.0 4.8 84.7 7.9 84.7 6.2 NS
Women (%) 62.5 83.3 68.8 NS
MNA (nº points) 21.7 4.7^ 16.8 5.2^ 17.6 2.8 0.037 (1)
MMSE (nº points) 26.6 2.9^* 15.7 4.5^ 10.1 7.1* (2) 23: cognitive impairment
Normality
(n = 8)
CIND
(n = 12)
Dementia
(n = 16)
p Reference values
Energy (kcal) 1622.0 281.5 1445.0 416.4 1359.6 263.1 NS 2100 1700
P t i (%) 14 5 2 3 15 6 3 1 17 1 3 5 NS 12 17
Nursing elderly
Methodology
1. A higher intake of total fatty acids, monounsaturated and
polyunsaturated fatty acids, fibre, folic acid, vitamins C and E,
iodine and copper could contribute to better cognitive function.
2. All residents, regardless of their cognitive status, conducted a
nutritionally unbalanced and deficient diet, suggesting that supply
and/or food intake were insufficient.
3. Although there is no consensus in the scientific evidence, the
nutritional profile of the dietary intake observed in all residents
could be a risk factor for cognitive decline.
4. An improvement of food intake may have a beneficial effect not
only on the overall nutritional status but also in cognitive function.
5. To improve dietary intake, in addition to offering healthy menu, is
necessary to control and stimulate food intake.
6. Food education workshops for residents and family, and their
participation in choosing the menu, could be a strategy to
stimulate food intake.
Conclusions
Bibliography
(1) OMS. Envejecimiento activo: un marco político. Rev Esp Geriatr Gerontol 2002; 37(S2): 74-105; (2) Milà R. et al. Prevalencia de malnutrición en la población anciana española: una revisión sistemática. Med Clin 2012; 139(11):502 – 508; (3) Reuss JM.
Atención nutricional en residencias geriátricas. En: Gómez-Candela C, Reuss JM. Manual de recomendaciones nutricionales en pacientes geriátricos. Barcelona, Novartis Consumer Health 2004: p. 285 – 293; (4) Arbonés G. et al. Nutrición y
recomendaciones para personas mayores. Grupo de trabajo “Salud pública” de la Sociedad Española de Nutrición (SEN). Nutr Hosp 2003; 18: 109-137; (5) Smith PJ. et al. Diet and neurocognition: review of evidence and methodological considerations.
Curr Aging Sci 2010: 3(1): 57-66; (6) Solfrizzi V. et al. Dietary fatty acids in dementia and predementia syndromes: epidemiological evidence and possible underlying mechanism. Ageing Res Rev 2010; 9(2): 184-199; (7) Morris MS. The role of B vitamins in
preventing and treating cognitive impairment and decline. Adv Nutr 2012; 3(6): 801-812; (8) Solfrizzi V. et al. Mediterranean diet in predementia and dementia syndromes. Curr Alzheimer Res 2011; 8(5): 520-54.
(CIND: cognitive impairment no dementia; SFA: saturated fatty acids; MUFA: monounsaturated fatty acids; PUFA: polyunsaturated fatty acids).
(1) Normality vs CIND p = 0.054; Normality vs Dementia p = 0.094.
Proteins (%) 14.5 2.3 15.6 3.1 17.1 3.5 NS 12 – 17
Carbohydrates (%) 49.6 2.9 53.3 6.9 48.2 6.3 NS 55 – 75
Fat (%) 36.0 4.0^* 31.3 5.0^ 34.8 3.7* (1) 30 – 35
SFA (%) 12.2 2.0 11.5 2.9 12.6 1.9 NS < 7 – 10
MUFA (%) 14.0 2.1^ 11.3 2.7^ 12.5 2.2 0.042 > 13
PUFA (%) 5.2 1.2^ 3.8 1.1^ 4.4 1.4 0.058 < 10
α-linolenic acid (g) 0.47 0.19 0.37 0.15 0.37 0.16 NS 2
Docosahexaenoic acid (g) 0.11 0.15 0.09 0.10 0.04 0.06 NS 0.2
Cholesterol (mg) 310.2 190.0 249.8 132.8 292.8 119.6 NS < 300
Fibre (g) 14.2 4.5* 10.2 4.7 7.6 4.2* 0.005 20 – 30
Thiamine (mg) 1.09 0.22 1.04 0.58 1.22 0.68 NS 1.2 1.1
Riboflavin (mg) 1.11 0.34 1.12 0.27 1.18 0.29 NS 1.3 1.2
Niacin (mg) 12.3 4.4 11.0 3.7 11.6 3.5 NS 16 15
Vitamin B6 (mg) 1.25 0.36 0.97 0.36 1.07 0.35 NS 1.4 1.2
Folic acid (mcg) 173.6 51.6* 139.5 71.4 101.2 41.5* 0.013 400
Cobalamin (mcg) 3.6 2.0 3.1 1.0 3.4 1.6 NS 3
Vitamin C (mg) 116.5 60.0 89.2 47.2 66.8 39.4 0.051 100
Vitamin A (mcg) 1417.3 996.1 811.2 604.8 1303.7 773.6 NS 1000 800
Vitamin D (mcg) 3.7 4.6 2.0 1.8 1.9 1.8 NS 10 – 15
Vitamin E (mg) 3.7 1.3^ 2.4 1.4^ 2.9 1.0 0.065 12 – 15 11 – 15
Calcium (mg) 762.4 254.8 671.9 200.2 678.9 214.2 NS 1000
Magnesium (mg) 187.6 33.5 155.0 51.8 150.7 37.9 NS 420 350
Phosphorus (mg) 928.7 233.1 836.7 192.3 857.0 189.8 NS 700
Iron (mg) 8.4 1.4 7.4 2.9 7.1 2.2 NS 10
Zinc (mg) 6.6 1.4 6.0 2.6 5.7 1.5 NS 10 7
Iodine (mcg) 67.7 12.7 48.1 20.5 59.4 28.3 0.067 150
Selenium (mcg) 62.4 17.2 55.3 27.3 45.6 21.7 NS 55
Copper (mcg) 926.5 409.9 783.6 623.7 499.8 256.2 0.044 1500 – 3000
Sodium (mg) 1455.7 364.4 1131.1 392.5 1191.3 409.9 NS 2500 – 5000
Potassium (mg) 1958.9 351.4 1641.1 412.0 1672.5 348.6 NS 1600 – 2000
51 residents
No informed consent: 4
Death: 1
Physical deterioration very advanced: 5
Intake outside the residence: 2
Aggressiveness: 3
36 residents
(10 men + 26 women)
Cognitive status: Mini Mental State Examination (MMSE)
Nutritional status: Mini Nutritional Assessment (MNA)
Nutritional intake: dietary record by double weight program Dietsource 2.0
(3 days: 2 working + 1 holiday)
Statistical analysis: SPSS vs 11.0
Mean ± DE; Tukey-honestly and Kruskal-Wallis
RESULTS
ABSTRACT
ANNA BONAFONT I CASTILLO
anna.bonafont@uvic.cat
METHODOLOGY
Interpretatitive constructivist
paradigm. Case Study
Individuals aged over 70 years old with
mild or moderate loss of functional
autonomy, who live at home and who
have preserved cognitive skils
4 people (71-94 years old)
2 Men 2 Women
Semi-structured in-depth interview
REFERENCES
(1) Anaut, M. (2010) La relation de soin dans le cadre de la résilience. Informations Sociales (2) Anaut, M (2005) Regards sur la résilience et la singularité des situations de handicap. Reliance, 16; (3)
Baltes, P.B. (1997) On the incomplete architecture of human ontogeny: Selection, optimization and compensation as foundation of developmental theory. American Psychologist, 52; (4) Cyrulnik, B. (2005)
Résilience des sujets âgées. Synapse, juin; (5) De Tychey, C. (2001) Surmonter l’adversité: les fondements dynamiques de la résilience. Cahiers de Psychologie Clínique, 16; (6) Ennuyer, B. (2004) Les
malentendus de la dépendance. Paris: Dunod; (7) Galende, E. (2004) « Subjetividad y resiliencia: del azar y la complejidad » A: Melillo, A et al, Resiliencia y subjetividad. Buenos Aires: Paidos; (8)Ribes,
G. (2006) Résilience et viellissement. Reliance 21; (9) Zurkefeld, R. et al (2007) Desarrollo resiliente y redes vinculares. Congreso de Psiquiatría. De Mar del Plata.
σ
σ
σ
Note: The representation of the FE mesh and the colorization under stress do not represent real cases. They are purely representative for the methodology.
σ
σ σ
Decision Support System (DSS) for Risk Assessment in Low-Impact
Femoral Fractures
Bosch J1, Idelsohn S2, Montesinos J1, Koch MA2.
1Althaia, Xarxa Assistencial Universitaria de Manresa, F.P. Manresa, Spain
2Fundació CTM Centre Tecnològic, Manresa, Spain
References: (1) N Engl J Med 2008;358(14):1474-1482 (2)N Engl J Med 2007;357(18):1799-1809. (3) JAMA 2001;285(21):2736-
2742. (4) Rev Esp Geriatr Gerontol 2007;42:135-141. (5) JAMA 2009;302(8):883-889 (6) CMAJ 2009;DOI:10.1503/cmaj.091212 (7)
Clinic Rev Bone Miner Metab; DOI 10.1007/s12018-009-9054-6 (8) Clinical Decision Support Systems: Theory and Practice,
Springer-Verlag New York, Inc., Secaucus, NJ, 1998 (9) Med Eng Phys 2003;25:781-787
Fundació
Parc de
Salut
· Exchange of best practices in Neurosciences
· International collaboration of companies and academics
· Development of innovative clusters
NeuroRescue
NEUROsciences RESearch Clusters of Excellence
Supported by the EC's Regions of Knowledge Programme
www.neurorescue.eu
Follow NeuroRescue
VTT Active Ageing Forum
ActiveAgeing@vtt.fi
www.vtt.fi
WHAT ARE WE AIMING AT?
To improve the quality of life of
people of third age (55+) by means of
ICT services.
Trends:
1) Individualism
2) Forever young
3) Brain training
4) Travelling & Seasonal Migration
5) Grey Panthers at Work
Offerings:
1) Tackle the trends with new uses for
technologies
2) Introduce service solutions for
active ageing
3) Bring value for clients and ’worth’
to users
4) Create new business possibilities
Value for clients/stakeholders:
• knowledge pool on ageing users &
technology
• direct communication with
end-users
• synergy in the network
• end user empowerment
What and how?
• adopting new Human-Driven
design models & methods
(e.g. empowering design
practices, co-innovation tools,
IHME – innovation and co-creation
spaces, ethical design)
• see-try-think-share; win-win
• user studies, Life-Based Design
• design & innovation workshops
• concept design &
(agile)prototyping
• evaluation of prototypes, products
& services
• B2C & B2B
Contacts:
Veikko Ikonen
Veikko.ikonen@vtt.fi
Jaana Leikas
Jaana.Leikas@vtt.fi
QBSTIC Salut i Tecnologia S.L hola@isalutacasa.com iSalutacasa.com
24/365
Outcome for patient?
Being at home, his known and natural environment
Advanced identification of unbalances
Reduction of emergencies
Reduction of adverse effects
Improvement of life quality
Low cost vs better effectiveness: patient’s active role with self-care
Opportunities and benefits:
More autonomy and psychological comfort for the patient and familyMore autonomy and psychological comfort for the patient and family
Increasing physical activity and healthIncreasing physical activity and health
Alternative to senior residence – staying at homeAlternative to senior residence – staying at home
Cost-Effective solution: Prevention improvement and health cost
reduction
Cost-Effective solution: Prevention improvement and health cost
reduction
Home nurse services and telemonitoring
Abstract
Telemonitoring technology to improve health care
services for chronic patients at home, with special
focus on elderly andvulnerable people.
Telemonitoring, either for health care professionals
(nurse and general practitioners GP) or for patient
self-measurements, consisting on respiratory-rate,
heart-rate, blood pressure, oxygen saturation,
weight, body temperature, electrocardiograph and
blood glucose measurements. Additionally, the
patients will complete a qualitative symptom
questionnaire daily using the telemonitoring system.
The system generates automatic alarms, based on
the defined intelligence and individual thresholds,
shown at the dashboard and sent by mail and SMS
to the nurse or GP responsible. Regular telephone
calls and visits are defined under the Nurse Care
Plan for the patient (Pla de Cures d’Infermeria PCI).
Telemonitoring ubiquitous intervention aimed at
home care patients with heart failure (HF), chronic
lung disease (CLD) –such chronic obstructive
pulmonary disease (COPD), asthma and other
respiratory conditions-, diabetis, hypertension
(HTN) and fragile patients.
Telemonitoring combined with home nurse services
is the alternative mode of health care provision for
medically unstable elderly patients, who bear a high
degree of physical and functional deterioration and
also often with high degree of dependency.
Careline@PRO: Telemonitoring system for the professionals. Managing multiple patients
assigned to different health careprofessionals (nurse and GP).
Careline@HOME: Telemonitoring system for the patient at home. Gives to the patient the
ability to measure its biometric parameters and provide qualitative symptom feedback in a
daily basis to nurse and GP.
Complex patient
High risk patient
Stable chronic patient
Healthy patient
Case
manag.
Case
manag.
Disease
management
Disease
management
Disease self-controlDisease self-control
Health prevention and
promotion
Health prevention and
promotion
Telemonitoring technology for home health care services
Local
Ubiquitous
Pro-active
Personalized
Remote management
Real Time
Intelligence
Patient/pathology set-up
Devices,PDA/Smartphone(Bluetooth)
WebManager/Extranet
GPRS/3G, VPN
the
Company
Ventura Medical Technologies is a com-
panyfocusedonthedevelopmentofinno-
vativeproductsandmethodsforproviding
integral solutions of multi-technological
engineering to the ideas from the profes-
sionals of the health sector.
never
stop
innovating
Obstetric material
Development of an obstetric pro-
duct to facilitate the birth process
and avoid complications, using
new material and improving the
current technique.
Head office
Ventura Medical
Technologies, SL
La Roca del Vallès (Spain)
Ctra. de Valldeoriolf, km 0.2
08430 La Roca del Vallès
Barcelona (Spain)
Telephone: +34 93 870 49 39
Fax: +34 93 879 17 27
info@venturamedicaltechnologies.com
www.venturamedicaltechnologies.com
Production plants:
Baldomero
Ventura, SL
La Roca del Vallès (Spain)
Ctra. de Valldeoriolf, km 0.2
08430 La Roca del Vallès
Barcelona (Spain)
Telephone: +34 93 870 49 39
Fax: +34 93 879 17 27
BVentura Corp.
Houston
Houston (Texas/USA)
9407 New Century Drive
Pasadena, Houston
77507 Texas
Telephone: +1 281 474 13 82
Fax: +1 281 474 13 96
BVentura Corp.
Suzhou
Suzhou (China)
146 Putian Road
Suzhou Industrial Park
Jiangsu, P.R. China
Telephone: +86 186 625 280 12
X-Ray Machine
Radiodiagnostic machines for the
oncology sector that make ima-
ges available during intervention,
reducing surgical invasion of the
patient, surgery time and making
the job easier for professionals.
Osteosynthesis
device
New device and surgery kit that
allows the development of a mi-
nimally invasive procedure and
solves a lot of the existing pro-
blems of the products.
Oncological
marker
Development of a device that will
show oncologists, radiologists
and surgeons the correct outline
of patients’ tumours.
INNOVATION + BUSINESS FOCUS = SUCCES
Our
Products
Contact
us!
Improvements in rehabilitation
and neurorehabilitation
Technological and clinical innovation of the technologies
applied in situations involving disability (rehabilitation
and neurorehabilitation) that favour personal indepen-
dence, patient motivation and respond to the demands
of technological change.
Pectus UP Surgery Kit
the solution for Pectus Excavatum
HELP: “Home-based Empowered Living for
Parkinson’s disease patients”
Jaume Romagosa and Joan Cabestany
Technical Research Centre for the Dependency Care and Autonomous Living– CETpD / Technical University of Catalunya—UPC
Objectives
Parkinson Disease
The HHELP project (Home-based Empowered living for Parkinson's Disease Patients) aims at
developing a comprehensive system able to administer drug therapy in either continuous or on-
demand basis in order to manage disease progression and to mitigate Parkinson's disease
symptoms.
This project will be developed in a user-oriented way; thus, involving the users during the whole
lifetime of the project. It is important to remark that HELP users are not only patients, but also
medical doctors, relatives, nurses, etc. That is: each and every actor involved in the care process.
Inertial Sensor
Accelerometers, gyroscopes and magnetometers transducers capture physical signals produced by
the body motions; the sensor processes these signals in order to extract spatio-temporal properties
of the patient’s motions i.e., patient’s postures, energy expenditure and detection of daily living
activities. These variables are constantly sent to the gateway as controller’s inputs to ensure a
treatment consequent with the motor needs of the patients [3]. An internal communication module
is also required to establish constant information exchange with the gateway/controller.
Involved Partners
Bibliography
Parkinson’s disease (PD) is a pathology that is thought to affect more than four million people world
-wide. It is the fourth most frequent disorder of the nervous system, after epilepsy, brain vascular
disease and Alzheimer. The average age at diagnosis is 60 years. Given the rapidly advancing aging
population, PD is becoming a major public health issue in Europe [1].
One of the consequences of chronic diseases (e.g. Parkinson´s disease) in elderly people is the
limitation of their motion capacity and a straightforward lack of physical activity. This lost of
autonomy has a direct impact on the quality of life of the elders and their caregivers [2].
Germany
Italy
Spain
Israel
[1] Poto nik J (European Commissioner for Science and Research), A focus on Parkinson's disease and the
European Society, 1st European Brain Policy Forum, Brussels, 27.2.2008.
[2] Foerster,F. et al, Detection of posture and motion by accelerometry: A validation study in ambulatory
monitoring. CHB, vol 15, 1999.
System Components
About CETpD
The TTechnical Research Centre for Dependency Care and Autonomous Living (CETpD) is an applied
research and technology transfer centre created for the Universitat Politècnica de Catalunya and
the Fundació Hospital Comarcal Sant Antoni Abat on behalf of the Consorci de Servei a les
Persones de Vilanova i la Geltrú, with the aim of covering the demand for research and
development in the field of Geriatrics, Ambient Intelligence, Assistive Robotics and User Experience
Technologies.
The CCETpD has a team of highly qualified researchers with proven professional experience, skilled
technicians and research fellows. This team includes specialists in electronics, computational
intelligence, telecommunications, psychology, gerontology, medicine and behavior sciences, who
are skilled at performing interdisciplinary work.
The CCETpD carries out important applied research work and innovation focused on socially relevant
developments, especially on technologies and systems designed to enhance independent living of
elderly and disabled people.
HELP presents an innovative a comprehensive care approach to face PD, in order to maximize the
adherence to the treatment. The system is composed of four main elements:
An inertial sensor, located on the belt of the patient extracting information about the patient’s
physical activity (movement), in order to infer drug needs.
A portable subcutaneous pump dynamically delivering medication to the patient.
A non-invasive intraoral continuous drug delivery device.
A blood pressure monitor to supervise the patient’s overall health condition.
A mobile gateway in charge of the management of the network through wireless access.
[3] A. Rodríguez-Molinero, D.A. Pérez-Martínez, A. Català, J. Cabestany, Treatment of Parkinson’s disease could be
regulated by movement sensors: Subcutaneous infusion of varying apomorphine doses according to the
intensity of motor activity, Medical Hypotheses, V.72 N.4, Elsevier, 2009, pp 430-433.
Inertial Sensor
We constructed a wearable electronic device, the inertial sensor, able to measure inertial properties
of motion: it captures the acceleration produced on its own spatial frame G = [gx,gy,gz], and the
angle of rotation of the sagittal plane (frontal rotation).
68 70 72 74 76 78 80 82 84
-5
0
5
10
Acceleration values while standing, walking and seating
Time (s)
Acceleration(m/s2
)
2012 Edition boosted by
INNO4AGEING is a XISCAT Network event
Supported by
COORGANIZERS OF THE INNO4AGEING 2012 EDITION
PARC DE SALUT is conceived for the medical and health research as well and innovation. It carry
out activities with a high value on knowledge aimed at improving the health and wellbeing.
These activities are focused on different areas: Training, Research, Innovation and High value-
added services. Its Non-profit Private Foundation, supported by the Health Department of
Catalan Government acting as Innovation Hub on Medical Technology and Health solutions, it
coordinates XISCAT Network.
FUNDACIÓ ABAT is a Non-profit Private Foundation providing health and social services since
fourteenth century and XISCAT Member. Becoming foundation in 1913, since 2004 it has taken a
strategy of engagement in research, development and innovation (RDI), in the welfare of the
elderly and currently developing and managing research and innovation project on behalf of
companies providing health and social services: The Garraf Health Consortium (CSG), the Alt
Penedès Health Consortium (CSAP) and the Consortium for Service to the People (CSP).
INNO4AGEING 2012 EDITION
SPECIAL ACKNOWLEDGEMENT FOR THEIR CONTRIBUTION
The main organizers of INNO4AGEING would like
to acknowledge the valuable role of their partners
in the 2012 Edition
www.parcdesalut.com/ageing
Inno4 ageing posters_2012
Inno4 ageing posters_2012
Inno4 ageing posters_2012

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Inno4 ageing posters_2012

  • 1. 2012 Edition boosted by INNO4AGEING is a XISCAT Network event Supported by INNO4AGEING The international meeting point of Active Ageing in Catalonia
  • 2. 2012 Edition boosted by INNO4AGEING is a XISCAT Network event Supported by INNO4AGEING IS A TWO-DAY CONGRES RECOGNIZED AS EU INITIATIVE SUPPORTING THE EUROPEAN YEAR FOR ACTIVE AGEING AND SOLIDARITY BETWEEN GENERATIONS With a strong focus on improving senior's health and wellbeing through the analysis, debates and scientific and business networking based on innovations in Hospitals activity, it highlights cutting-edge technology and results on Ambient Assisted Living (AAL), Chronicity, Telemedicine, Rehabilitation, and Information and Communications Technology (ICT) in Health. INNO4AGEING IS A XISCAT NETWORK EVENT IMPULSING THE INTERNATIONALITY OF THE INNOVATION BASED ON MEDICAL ACTIVITY FOR CATALAN TERRITORY Located at Vilanova i la Geltrú, hosted by Fundació ABAT (XISCAT member at Garraf) and co- organized together with Parc de Salut (Catalan Innovation Hub on medical devices and health). Learn more about it on www.parcdesalut.com/ageing
  • 3. 2012 Edition boosted by INNO4AGEING is a XISCAT Network event Supported by HIGH-VALUE ON INNOVATION AT AGEING TAKE-CARE AND TREATMENTS ON GARRAF
  • 4. 2012 Edition boosted by INNO4AGEING is a XISCAT Network event Supported by XISCAT, the largest national Hospital, Medical & Socio- sanitary Centers Network working on R+D+i www.parcdesalut.com/xiscat is proud to introduce the INNO4AGEING poster compilation
  • 5. INNO4AGEING is a XISCAT Network event 2012 Edition boosted by Supported by 1. Mechatronics based rehabilitation at home 2. The educational & training needs of a group of careers of elderly people in Osona 3. Nutritional intake & cognitive status in nursing 4. The experience of functional autonomy loss in elderly people: The disregarded voices 5. Decision support system (DDS) for risk assessment in low impact femoral fractures 6. Portable and adaptable BELT 7. Neurosciences Research Cluster of Excellence 8. NeuroRescue 9. VTT Active Ageing Forum 10. i-salut a casa 11. Leading innovative Health Solutions: pectus UP Surgery Kit 12. HELP: Home-based Empowered Living for Parkinson’s disease patients 13. eCAALYX. Enhanced Complete Ambient Assisted Living Experiment SUMMARY
  • 6. May 1st 2010 - October 31st 2011 Mechatronics based Rehabilitation at Home
  • 7. Lead Participant Fontys University of Applied Sciences (School of Engineering, Mechatronics Department) - North Brabant (NL) Contact: Mr. Johan Vlugter (j.vlugter@fontys.nl) Participants Technical University of Catalonia-Industrial Equipment Design Center (CDEI-UPC) - Catalonia (ES) University of Brescia (Laboratory of Mechatronics, Faculty of Engineering) - Lombardy (IT) University of West Bohemia (Faculty of Applied Sciences, Department of Cybernetics) - South West Bohemia (CZ) Upper Austria University of Applied Sciences Research & Development - Upper Austria (AT) Companies & Institutions FOCAL Meditech B.V. - North Brabant (NL) Fitland - North Brabant (NL) Zuidzorg Foundation - North Brabant (NL) Privamed Inc. - South West Bohemia (CZ) Project data Duration 18 months, (May 1st 2010 - October 31st 2011) Budget: € 458.384,- ERDF funding € 369.551,30 Website www.mrh-project.eu About Innovation 4 Welfare Across Europe economic and demographic development pose new challenges in health related issues: a general tendency to prioritize on health and safety, the strong increase in welfare-related diseases and the increased need for (home) care for the ageing population, are causing health care costs to increase rapidly. Innovative solutions are necessary to meet these challenges and to avoid health care becoming unaffordable. Changing health needs are also an opportunity. It is an attractive target area for developing innovative new technologies and applications. Innovation 4 Welfare aims to stimulate the development of health related innovations. It is a four year mini-programme co-funded by the European Regional Development Fund (Interreg IVC) and has six partners throughout Europe. These partner regions exchange good practices, execute new innovation projects and try to influence regional policies by stimulating innovation in the field of health and safety. ( www.innovation4welfare.eu) Partner regions Innovation 4 Welfare involves partners from six regions across Europe Catalonia - Spain ACC1Ó Lombardy - Italy CESTEC Upper Austria - Austria TMG Tartu - Estonia Tartu Science Park South West Bohemia - Czech Republic RERA Addressed needs Against the background of increasing numbers of elderly people living longer (double ageing) and growing impor- tance of chronic diseases like diabetes (welfare diseases), continuing the increase of quality, access and efficiency of healthcare is considered one of the largest challenges in all Regions of the European Community. There is a clear understanding that better healthcare and quality of life in general can be achieved for people suffering from chronic diseases or disabilities through technological innovation initiated in particular by SME’s. Increasing numbers of (elderly) people need long term rehabilitation due to some disease or trauma. With execution of this project the participants aim to address societal, economical, medical and technological needs and challenges connected to the increasing demand of a high quality and high volume of affordable rehabilitation Mechatronics based Turning welfare challenges into business opportunities North Brabant - the Netherlands Province of North Brabant
  • 8. services to elderly and/or chronically ill people. Today therapy is offered to a patient by a therapist (usually one on one) in healthcare centres or at the patient’s private home. the years, travelling to a health centre will often be difficult, time consuming and expensive. of home bound patients will inevitably increase making the future of therapy at home on a ‘one on one’ basis an almost unsustainable service. a considerable impact on the daily routine of the patient, as planning is and will be mainly based on the schedules of the relative decreasing number therapists available. Activities for physiotherapy can be very roughly divided into: a body part and the therapist or a mechanical device counteracts it. With equipment available at healthcare centres a limited number of these treatments can be executed autonomously. The equipment commercially available to therapists today is still basically of mecha- nical nature, with some added electronic (recording) functionalities. More complex exercises are performed manually by the therapist on the patient. (moves the body part) and the patient should to some extend and ability counteract the imposed movement. In general this type of exercises is fully manually applied ‘one on one’ to the patient by the therapist. Rehabilitation treatments must be performed in many cases with considerable accuracy over longer periods of time to be effective and are therefore strenuous, labour intensive and expensive. Overall effectiveness and efficiency of therapy today still depends almost solely on the (manual) skills and experience of the therapist. There is an eminent need to address the growing demand of rehabilitation services, for the European Regions to be able to sustain in future years at least an acceptable but preferably an enhanced level of these services for the elderly and /or chronically ill people. Approach The basic approach of this project is to investigate the increase of overall quality, efficiency and effectiveness of physiotherapy to be achievable by introducing mechat- ronics based rehabilitation equipment designed for the use by patients at home under (remote) supervision by therapists and medical specialists and thus reducing the number of repetitive visits to or from therapists. Main activities The MRH project will focus on five main issues: 1. The present developments in rehabilitation 2. The success factors of a MRH application 3. The business opportunities for a MRH application 4. The design and development of MRH applications 5. The steps to be taken to make MRH applications a success At least five pilot applications will be developed to demonstrate the results of the studies. The results will be presented and discussed at five international meetings. The overall results will be used to compose a ‘white book’ on the MRH concept. Output The MRH subproject aims to develop a ‘white book’ on the different aspects of rehabilitation at home based on Mechatronics. Input for this white book will be obtained by consultation and by own research, and will be made available for regional policymakers, companies and authorities providing health and social care. Rehabilitation at Home Turning welfare challenges into business opportunities
  • 9. Subproject participants Mechatronics based Rehabilitation at Home Catalonia Technical University of Catalonia Universitat Politècnica Catalunya (UPC) Centre de Disseny d’Equipaments Industrials (CDEI) Llorens Artigues 4-6, Edif U Planta O 08028 Barcelona, Spain Contact: Sònia Llorens i Cervera Ilorens@cdei.upc.edu Website: www.cdei.upc.edu/index-en.php Lombardy University of Brescia Università degli Studi di Brescia (Unibs) Piazza del Mercato, 15 25121 Brescia, Italy Contact: Antonio Visioli antonio.visioli@ing.unibs.it Website: http://www.unibs.it/on-line/ateneo/Home.html North-Brabant (SLP) Fontys University of Applied Sciences Fontys Hogescholen (Fontys) Rachelsmolen 1 5612 MA Eindhoven, The Netherlands Contact: Johan Vlugter J.Vlugter@fontys.nl Website: www.fontys.edu South West Bohemia University of West Bohemia Západočeská univerzita v Plzni Univerzitni 8 306 14 Plzeň, Czech Republic Contact: Jaroslav Sobota jsobota@kky.zcu.cz Website: http://www.zcu.cz/en/ Upper Austria Upper Austria University of Applied Sciences Fachhochschule Oberöstereich (FHOO) Granisonstraße 21 4020 Linz, Austria Contact: Andreas Schrempf andreas.schrempf@fh-linz.at Website: http://www.fh-ooe.at/
  • 10. The educational and training needs of a group of carers of elderly people in Osona Vall Mayans, M.* *Departament Salut i Acció Social Facultat de Ciències de la Salut i el Benestar (FCSB)- UNIVERSITAT DE VIC (Barcelona) OBJECTIVES - To describe the functions of the carers of institutionalised elderly people - To develop and validate an instrument to analyse the tasks performed by the carers - To draw conclusions about the training needs of the Study Group (SG) and develop a training proposal Design: qualitative and descriptive study or diagnostic evaluation based on an analysis of the tasks performed by the SG: information obtained from in-depth interviews, Residential Care Home records, field observations based on a protocol and a checklist, fieldwork diary and documentary material. Study period: 2009-2011. Subjects and area studied: carers of the elderly in a formal setting; immigrant workers of varying age, status, socioeconomic status, gender, and level of training/education, etc.; staff without managerial responsibilities in privately owned or 3rd sector Residential Care Homes that are partly funded by the Generalitat de Catalunya; in Osona. .. RESULTS CONCLUSIONS MATERIAL AND METHODS View of the managers of the Residential Care Homes: Participants: 9 (64.3%) / 14 (100%) 1st interview: the carers have training needs 2nd interview: validated the classification of tasks and make suggestions regarding the training of the SG SG Interview: Profile Participants: 44 (100%)→ women (89%) aged between 19 and 56 (20-49) arrived in Spain between 1971 and 2008 without Spanish nationality, but with a Residence Permit (80%) educated to secondary level with little experience of caring for the elderly before starting their current job The SG feel they need training in: (approx. %) PERSONAL HYGIENE ___________ 32% ROOM TIDYING ___________ 32% TOILETING ________________ 86.5% NUTRITION AND FEEDING ________________ 59% PUTTING TO BED ________________ 29.5% RECORD KEEPING ___________ 91% MOVING THE ELDERLY PERSON _________ 41% NURSING CARE __________________ 86.4% PERSONAL RELATIONS ___________ 70.5% MEDICATION ___________ 70.5% CLEANING/IRONING/OTHER TASKS ______ 15.9% MEETINGS ___________ 43.2% ONGOING IN-HOUSE TRAINING __________ 93.2% OTHER ________________ 59.1% Interviews Observations 0 2 4 6 8 10 12 Numberofimmigrant carers Countries Country of origin of SG Direct observation of the SG: N = 6 (2 mornings + 2 afternoons + 2 nights, ≠ Homes → sample of approx. 13.5%), for 6–11½ hours (= length of shift) tasks performed: 132 / 220 (60% approx.), mainly priority and secondary time and staff are confirmed as insufficient to perform all the validated tasks many aspects of the work could be improved Triangulation The quality of the work of the SG needs to be improved by the suggested training 0 5 10 15 20 Centelles Manlleu SantQuirze de Besora Taradell Tona Torelló Roda de Ter Numberofimmigrant carers Towns Location of Homes and SG the capacities and skills the immigrant carers have are sufficient to cover some of the needs of the elderly residents the carers feel they need to learn: to do some tasks, to improve others and to extend their skills, even in areas outside their professional responsibilities to facilitate the learning of the SG, it is proposed that a training programme should be developed, using methods appropriate for adult learners who have some experience, once their specific educational and training needs have been evaluated
  • 11. UNIVERSITAT DE VIC Nutritional intake and cognitive status in nursing home residents MARÍA ESPERANZA DUDET CALVO esperanza.dudet@uvic.cat Department of Health and Social Action Faculty of Health Sciences and Welfare – University of Vic (Barcelona) Introduction: Malnutrition is a common problem in nursing homes, and an inadequate nutrition can contribute to cognitive impairment. The aim of this study was to determine the nutritional intake profile of nursing home residents, related to cognitive status. Methodology: A cross-sectional study was performed in 36 elderly (10 men and 26 women) institutionalized in a nursing home. Cognitive status was determined using the Mini Mental State Examination (MMSE), nutritional status whit the Mini Nutritional Assessment (MNA), and nutritional intake using double weight dietary record for three days. Results: All residents showed excessive intake of saturated fatty acids and deficient in energy, carbohydrates, -linolenic acid, docosahexaenoic acid, fibre, riboflavin, niacin, folic acid, vitamins B6, D and E, calcium, magnesium, iron, zinc, iodine, sodium and copper. Cognitively normal elderly showed better scores in Mini Mental State Examination (21.7 ± 4.7 vs 16.8 ± 5.2, p = 0.037), and higher intake of total fatty acids (36.0 4.0 vs 31.3 5.0, p = 0. 54; 36.0 4.0 vs 34.8 3.7, p = 0.094), monounsaturated fatty acids (14.0 ± 2.1 vs 11.3 ± 2.7, p = 0.042), polyunsaturated fatty acids (5.2 ± 1.2 vs 3.8 ± 1.1, p = 0.058), fibre (14.2 ± 4.5 vs 7.6 ± 4.2, p = 0.005), folic acid (173.6 ± 51.6 vs 101.2 ± 41.5, p = 0.013), vitamin C (116.5 ± 60.0 vs 89.2 ± 47.2 vs 66.8 ± 39.4, p = 0.051), vitamin E (3.7 ± 1.3 vs 2.4 ± 1.4, p = 0.065), iodine (67.7 ± 12.7 vs 48.1 ± 20.5, p = 0.067) and copper (926.5 ± 409.9 vs 783.6 ± 623.7 vs 499.8 ± 256.2, p = 0.044) that cognitive impaired elderly. Conclusions: A higher intake of total fatty acids, monounsaturated and polyunsaturated fatty acids, fibre, folic acid, vitamins C and E, iodine and copper could contribute to better cognitive function. All residents, regardless of their cognitive status, conducted a nutritionally unbalanced and deficient diet. Key words: nutritional intake, nutritional status, cognitive status, nursing home elderly. Abstract Introduction One of the health policy from WHO to promote active aging is to reduce the risk factors related to the causes of major diseases, and to increase factors that protect health; nutrition / feeding is one of the factors to address. Malnutrition is a common health problem in nursing homes. Cognitive impairment / dementia is one of the features that characterize the profile of institutionalized elderly in these centres. Cognitive decline may be attributable, in part, to inadequate nutrition. Considering all these factors, we carried out this study in order to know the nutritional intake profile of nursing home residents, based on cognitive status. Results Table 1. Baseline characteristics of study sample based on cognitive status. (CIND: cognitive impairment no dementia; MNA: Mini Nutritional Assessment; MMSE: Mini Mental State Examination). (1) Satisfactory nutritional status: 24 points; Risk of malnutrition: 17 – 23.5 points; Malnutrition: < 17 points. (2) Normality vs CIND p = 0.000; Normality vs Dementia p = 0.000; CIND vs Dementia p = 0.035. Table 2. Energy and nutrients intake based on cognitive status. Normality (n = 8) CIND (n = 12) Dementia (n = 16) p Reference values Age (years) 89.0 4.8 84.7 7.9 84.7 6.2 NS Women (%) 62.5 83.3 68.8 NS MNA (nº points) 21.7 4.7^ 16.8 5.2^ 17.6 2.8 0.037 (1) MMSE (nº points) 26.6 2.9^* 15.7 4.5^ 10.1 7.1* (2) 23: cognitive impairment Normality (n = 8) CIND (n = 12) Dementia (n = 16) p Reference values Energy (kcal) 1622.0 281.5 1445.0 416.4 1359.6 263.1 NS 2100 1700 P t i (%) 14 5 2 3 15 6 3 1 17 1 3 5 NS 12 17 Nursing elderly Methodology 1. A higher intake of total fatty acids, monounsaturated and polyunsaturated fatty acids, fibre, folic acid, vitamins C and E, iodine and copper could contribute to better cognitive function. 2. All residents, regardless of their cognitive status, conducted a nutritionally unbalanced and deficient diet, suggesting that supply and/or food intake were insufficient. 3. Although there is no consensus in the scientific evidence, the nutritional profile of the dietary intake observed in all residents could be a risk factor for cognitive decline. 4. An improvement of food intake may have a beneficial effect not only on the overall nutritional status but also in cognitive function. 5. To improve dietary intake, in addition to offering healthy menu, is necessary to control and stimulate food intake. 6. Food education workshops for residents and family, and their participation in choosing the menu, could be a strategy to stimulate food intake. Conclusions Bibliography (1) OMS. Envejecimiento activo: un marco político. Rev Esp Geriatr Gerontol 2002; 37(S2): 74-105; (2) Milà R. et al. Prevalencia de malnutrición en la población anciana española: una revisión sistemática. Med Clin 2012; 139(11):502 – 508; (3) Reuss JM. Atención nutricional en residencias geriátricas. En: Gómez-Candela C, Reuss JM. Manual de recomendaciones nutricionales en pacientes geriátricos. Barcelona, Novartis Consumer Health 2004: p. 285 – 293; (4) Arbonés G. et al. Nutrición y recomendaciones para personas mayores. Grupo de trabajo “Salud pública” de la Sociedad Española de Nutrición (SEN). Nutr Hosp 2003; 18: 109-137; (5) Smith PJ. et al. Diet and neurocognition: review of evidence and methodological considerations. Curr Aging Sci 2010: 3(1): 57-66; (6) Solfrizzi V. et al. Dietary fatty acids in dementia and predementia syndromes: epidemiological evidence and possible underlying mechanism. Ageing Res Rev 2010; 9(2): 184-199; (7) Morris MS. The role of B vitamins in preventing and treating cognitive impairment and decline. Adv Nutr 2012; 3(6): 801-812; (8) Solfrizzi V. et al. Mediterranean diet in predementia and dementia syndromes. Curr Alzheimer Res 2011; 8(5): 520-54. (CIND: cognitive impairment no dementia; SFA: saturated fatty acids; MUFA: monounsaturated fatty acids; PUFA: polyunsaturated fatty acids). (1) Normality vs CIND p = 0.054; Normality vs Dementia p = 0.094. Proteins (%) 14.5 2.3 15.6 3.1 17.1 3.5 NS 12 – 17 Carbohydrates (%) 49.6 2.9 53.3 6.9 48.2 6.3 NS 55 – 75 Fat (%) 36.0 4.0^* 31.3 5.0^ 34.8 3.7* (1) 30 – 35 SFA (%) 12.2 2.0 11.5 2.9 12.6 1.9 NS < 7 – 10 MUFA (%) 14.0 2.1^ 11.3 2.7^ 12.5 2.2 0.042 > 13 PUFA (%) 5.2 1.2^ 3.8 1.1^ 4.4 1.4 0.058 < 10 α-linolenic acid (g) 0.47 0.19 0.37 0.15 0.37 0.16 NS 2 Docosahexaenoic acid (g) 0.11 0.15 0.09 0.10 0.04 0.06 NS 0.2 Cholesterol (mg) 310.2 190.0 249.8 132.8 292.8 119.6 NS < 300 Fibre (g) 14.2 4.5* 10.2 4.7 7.6 4.2* 0.005 20 – 30 Thiamine (mg) 1.09 0.22 1.04 0.58 1.22 0.68 NS 1.2 1.1 Riboflavin (mg) 1.11 0.34 1.12 0.27 1.18 0.29 NS 1.3 1.2 Niacin (mg) 12.3 4.4 11.0 3.7 11.6 3.5 NS 16 15 Vitamin B6 (mg) 1.25 0.36 0.97 0.36 1.07 0.35 NS 1.4 1.2 Folic acid (mcg) 173.6 51.6* 139.5 71.4 101.2 41.5* 0.013 400 Cobalamin (mcg) 3.6 2.0 3.1 1.0 3.4 1.6 NS 3 Vitamin C (mg) 116.5 60.0 89.2 47.2 66.8 39.4 0.051 100 Vitamin A (mcg) 1417.3 996.1 811.2 604.8 1303.7 773.6 NS 1000 800 Vitamin D (mcg) 3.7 4.6 2.0 1.8 1.9 1.8 NS 10 – 15 Vitamin E (mg) 3.7 1.3^ 2.4 1.4^ 2.9 1.0 0.065 12 – 15 11 – 15 Calcium (mg) 762.4 254.8 671.9 200.2 678.9 214.2 NS 1000 Magnesium (mg) 187.6 33.5 155.0 51.8 150.7 37.9 NS 420 350 Phosphorus (mg) 928.7 233.1 836.7 192.3 857.0 189.8 NS 700 Iron (mg) 8.4 1.4 7.4 2.9 7.1 2.2 NS 10 Zinc (mg) 6.6 1.4 6.0 2.6 5.7 1.5 NS 10 7 Iodine (mcg) 67.7 12.7 48.1 20.5 59.4 28.3 0.067 150 Selenium (mcg) 62.4 17.2 55.3 27.3 45.6 21.7 NS 55 Copper (mcg) 926.5 409.9 783.6 623.7 499.8 256.2 0.044 1500 – 3000 Sodium (mg) 1455.7 364.4 1131.1 392.5 1191.3 409.9 NS 2500 – 5000 Potassium (mg) 1958.9 351.4 1641.1 412.0 1672.5 348.6 NS 1600 – 2000 51 residents No informed consent: 4 Death: 1 Physical deterioration very advanced: 5 Intake outside the residence: 2 Aggressiveness: 3 36 residents (10 men + 26 women) Cognitive status: Mini Mental State Examination (MMSE) Nutritional status: Mini Nutritional Assessment (MNA) Nutritional intake: dietary record by double weight program Dietsource 2.0 (3 days: 2 working + 1 holiday) Statistical analysis: SPSS vs 11.0 Mean ± DE; Tukey-honestly and Kruskal-Wallis
  • 12. RESULTS ABSTRACT ANNA BONAFONT I CASTILLO anna.bonafont@uvic.cat METHODOLOGY Interpretatitive constructivist paradigm. Case Study Individuals aged over 70 years old with mild or moderate loss of functional autonomy, who live at home and who have preserved cognitive skils 4 people (71-94 years old) 2 Men 2 Women Semi-structured in-depth interview REFERENCES (1) Anaut, M. (2010) La relation de soin dans le cadre de la résilience. Informations Sociales (2) Anaut, M (2005) Regards sur la résilience et la singularité des situations de handicap. Reliance, 16; (3) Baltes, P.B. (1997) On the incomplete architecture of human ontogeny: Selection, optimization and compensation as foundation of developmental theory. American Psychologist, 52; (4) Cyrulnik, B. (2005) Résilience des sujets âgées. Synapse, juin; (5) De Tychey, C. (2001) Surmonter l’adversité: les fondements dynamiques de la résilience. Cahiers de Psychologie Clínique, 16; (6) Ennuyer, B. (2004) Les malentendus de la dépendance. Paris: Dunod; (7) Galende, E. (2004) « Subjetividad y resiliencia: del azar y la complejidad » A: Melillo, A et al, Resiliencia y subjetividad. Buenos Aires: Paidos; (8)Ribes, G. (2006) Résilience et viellissement. Reliance 21; (9) Zurkefeld, R. et al (2007) Desarrollo resiliente y redes vinculares. Congreso de Psiquiatría. De Mar del Plata.
  • 13. σ σ σ Note: The representation of the FE mesh and the colorization under stress do not represent real cases. They are purely representative for the methodology. σ σ σ Decision Support System (DSS) for Risk Assessment in Low-Impact Femoral Fractures Bosch J1, Idelsohn S2, Montesinos J1, Koch MA2. 1Althaia, Xarxa Assistencial Universitaria de Manresa, F.P. Manresa, Spain 2Fundació CTM Centre Tecnològic, Manresa, Spain References: (1) N Engl J Med 2008;358(14):1474-1482 (2)N Engl J Med 2007;357(18):1799-1809. (3) JAMA 2001;285(21):2736- 2742. (4) Rev Esp Geriatr Gerontol 2007;42:135-141. (5) JAMA 2009;302(8):883-889 (6) CMAJ 2009;DOI:10.1503/cmaj.091212 (7) Clinic Rev Bone Miner Metab; DOI 10.1007/s12018-009-9054-6 (8) Clinical Decision Support Systems: Theory and Practice, Springer-Verlag New York, Inc., Secaucus, NJ, 1998 (9) Med Eng Phys 2003;25:781-787
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  • 15. Fundació Parc de Salut · Exchange of best practices in Neurosciences · International collaboration of companies and academics · Development of innovative clusters NeuroRescue NEUROsciences RESearch Clusters of Excellence Supported by the EC's Regions of Knowledge Programme www.neurorescue.eu
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  • 19. VTT Active Ageing Forum ActiveAgeing@vtt.fi www.vtt.fi WHAT ARE WE AIMING AT? To improve the quality of life of people of third age (55+) by means of ICT services. Trends: 1) Individualism 2) Forever young 3) Brain training 4) Travelling & Seasonal Migration 5) Grey Panthers at Work Offerings: 1) Tackle the trends with new uses for technologies 2) Introduce service solutions for active ageing 3) Bring value for clients and ’worth’ to users 4) Create new business possibilities Value for clients/stakeholders: • knowledge pool on ageing users & technology • direct communication with end-users • synergy in the network • end user empowerment What and how? • adopting new Human-Driven design models & methods (e.g. empowering design practices, co-innovation tools, IHME – innovation and co-creation spaces, ethical design) • see-try-think-share; win-win • user studies, Life-Based Design • design & innovation workshops • concept design & (agile)prototyping • evaluation of prototypes, products & services • B2C & B2B Contacts: Veikko Ikonen Veikko.ikonen@vtt.fi Jaana Leikas Jaana.Leikas@vtt.fi
  • 20. QBSTIC Salut i Tecnologia S.L hola@isalutacasa.com iSalutacasa.com 24/365 Outcome for patient? Being at home, his known and natural environment Advanced identification of unbalances Reduction of emergencies Reduction of adverse effects Improvement of life quality Low cost vs better effectiveness: patient’s active role with self-care Opportunities and benefits: More autonomy and psychological comfort for the patient and familyMore autonomy and psychological comfort for the patient and family Increasing physical activity and healthIncreasing physical activity and health Alternative to senior residence – staying at homeAlternative to senior residence – staying at home Cost-Effective solution: Prevention improvement and health cost reduction Cost-Effective solution: Prevention improvement and health cost reduction Home nurse services and telemonitoring Abstract Telemonitoring technology to improve health care services for chronic patients at home, with special focus on elderly andvulnerable people. Telemonitoring, either for health care professionals (nurse and general practitioners GP) or for patient self-measurements, consisting on respiratory-rate, heart-rate, blood pressure, oxygen saturation, weight, body temperature, electrocardiograph and blood glucose measurements. Additionally, the patients will complete a qualitative symptom questionnaire daily using the telemonitoring system. The system generates automatic alarms, based on the defined intelligence and individual thresholds, shown at the dashboard and sent by mail and SMS to the nurse or GP responsible. Regular telephone calls and visits are defined under the Nurse Care Plan for the patient (Pla de Cures d’Infermeria PCI). Telemonitoring ubiquitous intervention aimed at home care patients with heart failure (HF), chronic lung disease (CLD) –such chronic obstructive pulmonary disease (COPD), asthma and other respiratory conditions-, diabetis, hypertension (HTN) and fragile patients. Telemonitoring combined with home nurse services is the alternative mode of health care provision for medically unstable elderly patients, who bear a high degree of physical and functional deterioration and also often with high degree of dependency. Careline@PRO: Telemonitoring system for the professionals. Managing multiple patients assigned to different health careprofessionals (nurse and GP). Careline@HOME: Telemonitoring system for the patient at home. Gives to the patient the ability to measure its biometric parameters and provide qualitative symptom feedback in a daily basis to nurse and GP. Complex patient High risk patient Stable chronic patient Healthy patient Case manag. Case manag. Disease management Disease management Disease self-controlDisease self-control Health prevention and promotion Health prevention and promotion Telemonitoring technology for home health care services Local Ubiquitous Pro-active Personalized Remote management Real Time Intelligence Patient/pathology set-up Devices,PDA/Smartphone(Bluetooth) WebManager/Extranet GPRS/3G, VPN
  • 21. the Company Ventura Medical Technologies is a com- panyfocusedonthedevelopmentofinno- vativeproductsandmethodsforproviding integral solutions of multi-technological engineering to the ideas from the profes- sionals of the health sector. never stop innovating Obstetric material Development of an obstetric pro- duct to facilitate the birth process and avoid complications, using new material and improving the current technique. Head office Ventura Medical Technologies, SL La Roca del Vallès (Spain) Ctra. de Valldeoriolf, km 0.2 08430 La Roca del Vallès Barcelona (Spain) Telephone: +34 93 870 49 39 Fax: +34 93 879 17 27 info@venturamedicaltechnologies.com www.venturamedicaltechnologies.com Production plants: Baldomero Ventura, SL La Roca del Vallès (Spain) Ctra. de Valldeoriolf, km 0.2 08430 La Roca del Vallès Barcelona (Spain) Telephone: +34 93 870 49 39 Fax: +34 93 879 17 27 BVentura Corp. Houston Houston (Texas/USA) 9407 New Century Drive Pasadena, Houston 77507 Texas Telephone: +1 281 474 13 82 Fax: +1 281 474 13 96 BVentura Corp. Suzhou Suzhou (China) 146 Putian Road Suzhou Industrial Park Jiangsu, P.R. China Telephone: +86 186 625 280 12 X-Ray Machine Radiodiagnostic machines for the oncology sector that make ima- ges available during intervention, reducing surgical invasion of the patient, surgery time and making the job easier for professionals. Osteosynthesis device New device and surgery kit that allows the development of a mi- nimally invasive procedure and solves a lot of the existing pro- blems of the products. Oncological marker Development of a device that will show oncologists, radiologists and surgeons the correct outline of patients’ tumours. INNOVATION + BUSINESS FOCUS = SUCCES Our Products Contact us! Improvements in rehabilitation and neurorehabilitation Technological and clinical innovation of the technologies applied in situations involving disability (rehabilitation and neurorehabilitation) that favour personal indepen- dence, patient motivation and respond to the demands of technological change. Pectus UP Surgery Kit the solution for Pectus Excavatum
  • 22. HELP: “Home-based Empowered Living for Parkinson’s disease patients” Jaume Romagosa and Joan Cabestany Technical Research Centre for the Dependency Care and Autonomous Living– CETpD / Technical University of Catalunya—UPC Objectives Parkinson Disease The HHELP project (Home-based Empowered living for Parkinson's Disease Patients) aims at developing a comprehensive system able to administer drug therapy in either continuous or on- demand basis in order to manage disease progression and to mitigate Parkinson's disease symptoms. This project will be developed in a user-oriented way; thus, involving the users during the whole lifetime of the project. It is important to remark that HELP users are not only patients, but also medical doctors, relatives, nurses, etc. That is: each and every actor involved in the care process. Inertial Sensor Accelerometers, gyroscopes and magnetometers transducers capture physical signals produced by the body motions; the sensor processes these signals in order to extract spatio-temporal properties of the patient’s motions i.e., patient’s postures, energy expenditure and detection of daily living activities. These variables are constantly sent to the gateway as controller’s inputs to ensure a treatment consequent with the motor needs of the patients [3]. An internal communication module is also required to establish constant information exchange with the gateway/controller. Involved Partners Bibliography Parkinson’s disease (PD) is a pathology that is thought to affect more than four million people world -wide. It is the fourth most frequent disorder of the nervous system, after epilepsy, brain vascular disease and Alzheimer. The average age at diagnosis is 60 years. Given the rapidly advancing aging population, PD is becoming a major public health issue in Europe [1]. One of the consequences of chronic diseases (e.g. Parkinson´s disease) in elderly people is the limitation of their motion capacity and a straightforward lack of physical activity. This lost of autonomy has a direct impact on the quality of life of the elders and their caregivers [2]. Germany Italy Spain Israel [1] Poto nik J (European Commissioner for Science and Research), A focus on Parkinson's disease and the European Society, 1st European Brain Policy Forum, Brussels, 27.2.2008. [2] Foerster,F. et al, Detection of posture and motion by accelerometry: A validation study in ambulatory monitoring. CHB, vol 15, 1999. System Components About CETpD The TTechnical Research Centre for Dependency Care and Autonomous Living (CETpD) is an applied research and technology transfer centre created for the Universitat Politècnica de Catalunya and the Fundació Hospital Comarcal Sant Antoni Abat on behalf of the Consorci de Servei a les Persones de Vilanova i la Geltrú, with the aim of covering the demand for research and development in the field of Geriatrics, Ambient Intelligence, Assistive Robotics and User Experience Technologies. The CCETpD has a team of highly qualified researchers with proven professional experience, skilled technicians and research fellows. This team includes specialists in electronics, computational intelligence, telecommunications, psychology, gerontology, medicine and behavior sciences, who are skilled at performing interdisciplinary work. The CCETpD carries out important applied research work and innovation focused on socially relevant developments, especially on technologies and systems designed to enhance independent living of elderly and disabled people. HELP presents an innovative a comprehensive care approach to face PD, in order to maximize the adherence to the treatment. The system is composed of four main elements: An inertial sensor, located on the belt of the patient extracting information about the patient’s physical activity (movement), in order to infer drug needs. A portable subcutaneous pump dynamically delivering medication to the patient. A non-invasive intraoral continuous drug delivery device. A blood pressure monitor to supervise the patient’s overall health condition. A mobile gateway in charge of the management of the network through wireless access. [3] A. Rodríguez-Molinero, D.A. Pérez-Martínez, A. Català, J. Cabestany, Treatment of Parkinson’s disease could be regulated by movement sensors: Subcutaneous infusion of varying apomorphine doses according to the intensity of motor activity, Medical Hypotheses, V.72 N.4, Elsevier, 2009, pp 430-433. Inertial Sensor We constructed a wearable electronic device, the inertial sensor, able to measure inertial properties of motion: it captures the acceleration produced on its own spatial frame G = [gx,gy,gz], and the angle of rotation of the sagittal plane (frontal rotation). 68 70 72 74 76 78 80 82 84 -5 0 5 10 Acceleration values while standing, walking and seating Time (s) Acceleration(m/s2 )
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  • 24. 2012 Edition boosted by INNO4AGEING is a XISCAT Network event Supported by COORGANIZERS OF THE INNO4AGEING 2012 EDITION PARC DE SALUT is conceived for the medical and health research as well and innovation. It carry out activities with a high value on knowledge aimed at improving the health and wellbeing. These activities are focused on different areas: Training, Research, Innovation and High value- added services. Its Non-profit Private Foundation, supported by the Health Department of Catalan Government acting as Innovation Hub on Medical Technology and Health solutions, it coordinates XISCAT Network. FUNDACIÓ ABAT is a Non-profit Private Foundation providing health and social services since fourteenth century and XISCAT Member. Becoming foundation in 1913, since 2004 it has taken a strategy of engagement in research, development and innovation (RDI), in the welfare of the elderly and currently developing and managing research and innovation project on behalf of companies providing health and social services: The Garraf Health Consortium (CSG), the Alt Penedès Health Consortium (CSAP) and the Consortium for Service to the People (CSP).
  • 25. INNO4AGEING 2012 EDITION SPECIAL ACKNOWLEDGEMENT FOR THEIR CONTRIBUTION The main organizers of INNO4AGEING would like to acknowledge the valuable role of their partners in the 2012 Edition www.parcdesalut.com/ageing