March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 1 From reducing mortality to...
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Transcript of March 17, 2007JEMH van Bronswijk, TUE-NL, Mortality - Morbidity 1 From reducing mortality to...
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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From reducing mortality to From reducing mortality to compressing morbiditycompressing morbidity
2007 International Conference on Gerontic Technology and Service Management
Nan Kai Institute of Technology, Taiwan
Keynote speech 4
Mach 27, 2007; 11.00-12.00 H
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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AgingAging
0
5
10
15
20
25
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35
40
45
Africa Latin America& the
Caribbean
Asia Oceania NorthernAmerica
Europe World
Region
Med
ian
ag
e o
f th
e p
op
ula
tio
n i
n y
ears
2005 2025
Source: http://esa.un.org/unpp
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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Life courseLife course
• Development = Growth = Aging
• Heredity (50%) + Environment (50%)
• Natural environments
• Technology changes environments
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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(Pre)History by Technology(Pre)History by TechnologyMedicine, Agriculture, IndustryMedicine, Agriculture, Industry
• Stone age: from the wake of humankind to villages
• Bronze age: walled towns come into being
• Iron age: living pace starts to increase
• Industrial age: mechanisation, electrification, ICT
Source: J.E. McClellan III, H. Dorn 2006. Science and technology in world history. 2nd edition. Baltimore: John Hopkins University Press
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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Technology generationsTechnology generationsin the Industrial agein the Industrial age
• Mechanical: increased urbanisation
• Electro-mechanical: decreased mortality
• Software: decrease of morbidity wanteddecrease of morbidity wanted
= Gerontechnology= Gerontechnology
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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Chronic conditionsChronic conditionsaccelerated aging of certain organs / tissuesaccelerated aging of certain organs / tissues
Examples:Examples:• Lungs: air pollution; indoor, outdoor
• Brains: lack of challenges nor social interaction
• Locomotory system: repetitive forces; work, leisure
• Circulatory system: lack of exercise
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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• 950-990x cases of acute Pontiac Fever
• 9-30x surviving Veteran-Disease patients, but with persisting chronic symptoms
• 1-20x fatal cases
Source: JEMH van Bronswijk e.a. 1999. Gezond en Duurzaam Bouwen (GeDuBo). Research Reportfor the Netherlands Ministry of Housing
Fate of 1000 Fate of 1000 LegionellaLegionella infections infectionsafter inhaling infested water dropletsafter inhaling infested water droplets
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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Allergy: of Mites and ManAllergy: of Mites and Man
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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From the NetherlandsFrom the Netherlands
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Improving healthImproving health
• Sustainable society, social cohesion
• Strengthening productivity, vitality
• Prolonging full citizenship
• Diminishing societal costs of care
• through Compressing MorbidityCompressing Morbidityby daily (geron)technology
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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Environmental factorsEnvironmental factorsin some chronic inflictionsin some chronic inflictions
• Outdoor and indoor air
• Potable water
• Liquid and solid waste
• Noise, sound, lighting
• Mobility, transport
• Social contacts and interaction
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Environmental engineeringEnvironmental engineering
• = to control environmental stress, by:
• Building construction
• Building services
• Civil / sanitary engineering
• Design of work processes
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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Preventive part of Preventive part of GerontechnologyGerontechnology
• Delaying chronic conditions
• Robust and feasible approach
• Smart, unobtrusive use of technology
• Acceptable daily technology
• Aimed also at younger age groups
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Ambient assisted livingAmbient assisted living
• Supports– healthy growth, development, aging
• Compensates– Weakening of functions
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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TQM of daily technologyTQM of daily technology
• TTotal QQuality MManagement (TQM)• HHazard AAnalysis CCritical CControl PPoint
(HACCP)• Guarantees quality during the whole
working life of a product or service• Originates from the food industry• Applicable to building services
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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HACCP steps for controlHACCP steps for control
• Base: Process description, end-product defined• 1: Process analysis• 2: CCritical CControl PPoints (CCPs)• 3: Critical limit / CCP• 4: Monitoring procedure / CCP• 5: Intervention at exceeded critical limit / CCP• 6: Verification procedure / CCP• 7: Registration & documentation procedures
(for in-company and out-company certification)
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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To reduce morbidity AND mortalityTo reduce morbidity AND mortality= Gerontechnology= Gerontechnology
• Suitable environments– from cradle to grave, HACCP control
• Smart coaching services
• Indoor environmental control– Home automation– Robotics
• Research– Impact, target, intervention site and type– for each single technology and technology system
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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010
20304050
60708090%
16-52 53 andover
Age in Yrs
Practical
Comfort
Security
Won't work
No control
Afraid
Expectations for smart housing
n = 42316-83 Yrs old56% female44% male30% home owners70% home renters
Source: S. Meyer, E. Schultz 2001. Vom Otto Normalverbraucher zur Smart Family. Berlin: Berliner Institut für Sozialforschung
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Expected advantages of smart housing
Germany 2001
• Daily living support• Safety & security• Comfort• Management of energy use• Other health issues not yet perceived
Source: S. Meyer, E. Schultz 2001. Vom Otto Normalverbraucher zur Smart Family. Berlin: Berliner Institut für Sozialforschung; http://www.bis-berlin.de/bestell/bestell_01.shtml
March 17, 2007 JEMH van Bronswijk, TUE-NL, Mortality - Morbidity
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Benefits of telemedicineBenefits of telemedicineA meta-analysis of 66 studies from 1966-2000
Source: D. Hailey, R. Roine, A. Ohinmaa 2002. Systematic review of evidence for the benefits of telemedicine Journal of Telemedicine and Telecare 8(Suppl 1):1-30
0
10
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Advantages Unclear Noadvantages
%
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For Sale: CottageFor Sale: CottageMarch 27, 2027March 27, 2027
• Pleasant neighbourhood• Modern kitchen• Luxury bathroom• A spacious living room• 3 Bedrooms • 103 Built-in butlers for leisure, support
and educationFree after: S. Marzano 2006. Ambient culture. Pp 35-52, in: E.H.L. Aarts, J.L. Encarnaçã0, editors, True visions; the emergence of ambient intelligence. Berlin: Springer
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Thank you for your attentionThank you for your attention