The fall-less city and other innovations for a healthier old age

The city of Liverpool is aiming to become a “fall-less” city – so that all older adults with limited or reduced mobility can venture forth into the streets, parks and other public places knowing that their chances of falling have been significantly reduced. One-third of older people in the UK experience a fall each year, rising to half the over-80s. Working with the Universities of Liverpool and Cambridge, the city council is implementing falls prevention and mitigation as part of its Age-Friendly City (AFC) initiative.

Promoted by the World Health Organisation, the age-friendly city movement has spread across the globe. With projections that half Europe’s population will be over 50 within a couple of decades and that the world will have more people over 60 than under 16 by 2050, the age-proofing of our environments is high on the agenda.

Already more than 500 million people over 65 live in cities. The urban old reach 250 million in Asia, 57 million in Latin America and 23 million in Africa. Indeed 90% of us, young and old, will live in urban environments by the end of the century.

The age-friendly city initiative is now an international movement supported by forums across the globe

The age-friendly city initiative is now an international movement supported by forums across the globe. The 2015 sustainable development goals (SDGs), call for inclusive urbanisation that enables older persons to participate in planning and decision-making, have access to safe and affordable public transport, and enjoy safe, inclusive and accessible green and public spaces.

While there is a strong emphasis on health, including the successful prevention of disease, disability, frailty and the promotion of healthy lives and activities, the age-friendly movement has moved beyond this to include the natural and built environment, cultural attitudes, social capital, equity and inclusion.

Investing in public transport is essential to create age-friendly cities. Older women in particular rely on public transport to make the complex journeys enabling them to juggle multiple roles as caregivers, housekeepers and income providers. Simple initiatives like those in Ukraine, promoted by the civil society organisation Turbota pro Litnih v Ukraini encourage older people to take an active role in improving public transport services, extending bus routes to poorly-served districts, and relocating bus stops so that local health centres can be easily accessed.

Similarly, various health initiatives encouraging physical activity and healthy eating, and creating communities that support people with dementia are being promoted. Colombia’s capital, Bogotá, has now implemented schemes with the assistance of HelpAge International (HAI) which provides guidance to families and carers of people with dementia, signposting them to resources and support available in the urban community.

However, there is much to do. The recent HAI Ageing and the City report found that in “the majority of low- and middle-income countries, most people aged over 50 reported not feeling safe walking home alone at night”. And reports have highlighted the increased vulnerability of older adults in times of crisis – such as the New Orleans hurricane in 2005 or the 2011 Japanese tsunami, where older people were disproportionality affected. While Ageing and the City may call for older people in be more involved in disaster preparedness planning, the evidence that this is happening is limited.

The future for the age-friendly city movement it to engage with the smart city debate. The Citris Invention Lab at the University of California is exploring “connected ageing landscapes” which link body, home, community and caregiving in one integrated technological flow.

Something as simple as interactive television promotes social and civic engagement – enabling older adults to connect with friends, neighbours and family, actively engage in community life, interact with healthcare provision, and earn an income.

But cutting-edge inventions – assistive technologies, smart medication management tools, smart body sensors, robotics and autonomous vehicles – can combine to provide a flow from person to home to cityscape. Connected medical devices using external sensors and remote monitoring have the potential to ease the struggles for older people in cities.

The city has the potential to become one integrated physical and virtual space – within which less-mobile adults can participate to the best of their ability. Age-friendly cities need to be smart cities. The age-friendly city movement must engage with the technology of the future to provide an urban environment where we can all experience a healthy old age.

Sarah Harper is professor of gerontology at the University of Oxford and supports the Bicester Healthy New Town initiative through research.

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The fall-less city and other innovations for a healthier old age

11 health innovations to drastically cut maternal and child mortality rates

Achieving the ambitious target to end maternal and child deaths, enshrined in the sustainable development goals (SDGs), will require ingenuity. The good news is that 11 health innovations could save more than 6 million mothers and children by 2030, if they are invested in and used widely in 24 priority countries.

When I began working in global health (at the World Health Organisation in 1990) 12.7 million children under five and 532,000 new mothers died every year. The challenge looked insurmountable. But in the two decades that followed, unprecedented global cooperation resulted in annual child deaths being cut by more than half, to 5.9 million in 2015, and annual maternal deaths to just over 300,000.

As impressive as the progress has been, it’s not enough. The current rate of decline in maternal and child mortality will not get us to the ambitious SDG targets by 2030. We need innovative tools and approaches to accelerate progress.

The 11 innovations modelled in our analysis, crowdsourced from experts around the world, are gamechanging health technologies and approaches that will have wide-scale impact, ensure healthier babies, protect mothers, and secure better health in the long term.

1 Injectable contraceptives

A new formulation that combines a widely used long-acting contraceptive in an easy-to-use injection is already improving access to this life-changing intervention by allowing community health workers to bring the drug directly to women. Several countries are even studying the potential for women to self-inject, further empowering women and their choices.

Modelling showed that this innovation, making long-acting contraception more accessible, could save more than 3 million lives – including women, newborns, and children – by helping women space their pregnancies in a healthy way.

Estimated lives saved graph

Estimated lives saved graph.

2 Better pneumonia treatment

Accurately diagnosing pneumonia in young children is very difficult. New tools to diagnose and treat the condition, including better respiratory rate monitors and portable pulse oximeters, can save many more lives from this disease, which is the leading infectious killer of children under five.

3 Kangaroo mother care

There is so much we can do now to give newborns a better chance at a healthy life. Studies have shown that kangaroo mother care, or skin-to-skin contact between the newborn and mother immediately after birth, improves breastfeeding and thermal regulation of newborns, both critical for survival in low-resource settings.

4 Chlorinators for water treatment

Beyond traditional interventions for mothers and newborns, we also need to ensure access to clean water. New technologies, like a chlorinator for community water treatment, are making the use of chlorine for disinfecting water easy and economical.

5 Antiseptic gel

Chlorhexidine, a low-cost antiseptic, is a very simple gel that, if applied to the newborn’s umbilical cord, can prevent deadly infections.

Despite widespread distribution of mosquito nets, malaria is still one of the world’s biggest killers. Photograph: Pius Utomi Ekpei/AFP/Getty Images

6 Single-dose anti-malarial drugs

Better drugs to protect against diseases like malaria are in the works, including a potent single-dose anti-malarial drug.

7 Neonatal resuscitators

As many as one in 10 newborns need help breathing at birth, new, simple, neonatal resuscitators can help prevent deaths.

8 Low-cost balloon tamponade

Women with postpartum haemorrhage can also be stabilised and treated by a balloon tamponade, a common tool in high-income countries. Recently, this tool has been adapted using readily available materials in low-income countries. Using the materials at hand, a healthcare provider can create a tamponade out of condoms and rubber tubing. Now simple low-cost kits and pre-assembled versions are available, that make this solution more accessible and effective.

9 Drugs to stop blood loss after childbirth

New forms of the drug oxytocin are currently being developed and tested that could increase coverage because they won’t require skilled health workers to administer or refrigeration for storage. These innovations could help ensure this highly effective drug reaches and treats hundreds of thousands of women at risk of death from postpartum haemorrhage (or severe bleeding after delivery) each year.

10 Rice fortification

For children who live in areas where rice is a staple food, we are seeing amazing developments in rice fortification, a process that enriches rice with vitamins and iron supplements. Better nutrition is at the core of better health and smarter ways to supplement staples and introduce foods with more nutritional value are essential.

11 New tests for a life-threatening maternal condition

Preeclampsia is another danger that affects more than one in 20 pregnant women. It is associated with dangerously high blood pressure that can lead to seizures. New diagnostic tools to treat preeclampsia will help identify at-risk women so that they can receive low-cost treatment.

How will these life-saving innovations be funded? Traditional donors cannot do it alone. Governments in low- and middle-income countries have a critical role to play and so do local entrepreneurs with the potential to take forward affordable solutions. The private sector and social impact investors, also want to engage. But all these groups need better data to assess what is available, what is coming soon, or where there is a gap that requires new ideas.

To achieve the goal of ending preventable maternal and child deaths, the world must invest in new and emerging health innovations so that bright ideas turn into real solutions. The lives of millions of women and children depend on it.

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11 health innovations to drastically cut maternal and child mortality rates

Healthcare innovations won’t cure global health inequality – political action will | Ben Ramalingam

The science fiction author William Gibson famously quipped the future is here, it’s just not evenly distributed. There is arguably no greater manifestation of our uneven world than that of healthcare. In the wealthiest countries, thousands of people in their 60s and 70s are kept alive with cardiac pacemakers that are remotely monitored over the internet, and adjusted by algorithms with no human intervention. In poorer states, three-quarters of a million children under five are dying each year because of shit in their water.

What can explain such unevenness, and what might be done about it? A scan of the proceedings at the World Health Summit in Berlin, which starts on Sunday, and where technological innovation is one of the major themes, is revealing. “Despite the exponential growth of scientific and technological development, low- and middle-income countries are still largely excluded from access to appropriate and affordable health technologies. Therefore novel technological devices need to be developed that can address health problems and improve quality of life,” reads the blurb for Monday’s keynote session.

Is this “must try harder” assessment correct? Is the solution to stark inequities in global health outcomes, and the enduring exclusion of developing countries from the benefits of innovation, to do more and better innovation?

Certainly, innovation for improved global health is arguably needed more than ever with the need to combat new and emerging diseases from Ebola to Zika and to find better ways of tackling non-communicable diseases such as cancer. But when we look at the innovations made in response to Ebola, we should pause for thought.

One stark example: in November 2014, when the Ebola outbreak was raging through west Africa, the US Food and Drug Administration went through an expedited approval process for a one-hour Ebola test, reducing the time for results by five hours from the previous fastest machines. The problem was that few west African countries had the resources to acquire the $ 40,000 machines or the skills to run them. They were, however, to be found in many US hospitals.

Or another example: Medécins Sans Frontières (MSF) helped to trial and demonstrate the effectiveness of new tests for TB in low income and humanitarian settings in 2011-12. But the price of the test made it prohibitive for many countries until a large public-private initiative emerged to subsidise the cost of the tests for 145 developing countries that were most affected by TB. Only then could this innovation benefit those who needed it most.

These are far from the only stories of how the poorest are excluded from the innovations that they need most. Once the stories start to accumulate, they turn from a trickle to a river to a flood. And one has to start wondering whether the old adage about famines is not relevant here: famines rarely result from a lack of food, rather it is lack of access to food. Similarly, the inequalities in tackling health problems are not because of a lack of innovation, but because of a lack of access to innovation. The binding constraints, I would argue, are seldom technical but instead related to the political and economic choices, which determine how innovations get funded, resourced and supported, by whom and for whom.

What to do in the face of such a system? The answer is to fight the innovation and political battles at the same time. We have to identify the gaps, and to test and trial the best new ideas that can address longstanding challenges faced by the world’s most vulnerable people, and build the evidence base that these ideas really can make a difference. Political leaders need to ensure that the scaling of new solutions includes those people who need innovation most, and who are most likely to be excluded from its benefits.

In doing so, it is worth looking to the work of organisations such as MSF, which do an admirable job of balancing the scientific and political aspects of advocacy in their Access to Medicines campaign. But we should also remember the work of pioneers, from Florence Nightingale to John Snow, who worked tirelessly to ensure their ideas benefited those in society who needed them the most.

The speakers and delegates at the World Health Summit should remember this pioneering spirit, which fused the spirit of medical discovery with political advocacy. And they should ensure that any statement calling for more and better medical technologies is quickly followed by a statement recognising that technology should at best be seen as a complement to, but never a substitute for, political action.

Healthcare innovations won’t cure global health inequality – political action will | Ben Ramalingam

How wellness innovations can decrease the burden of an ageing population

1 innovation could save the lives of hundreds of thousands of children who die every single 12 months from diarrhea-induced dehydration, explains Shirley Bergin. Photograph: Eranga Jayawardena/AP

The strain is on. Our international population is expanding older and sicker, putting an ever-increasing strain on healthcare systems worldwide. Without having significant healthcare innovation, we encounter a potential of epidemic-degree ailments that could bankrupt the economies of numerous nations – and reduce short uncountable lives.

An intensive globally search is underway for effective new ways to encourage and assistance prevention, achieve early detection and provide better diagnosis and treatment method. At TedMed, the health and medicine edition of the Ted conference, we regularly attribute cutting-edge medical technology of each and every type. By means of our innovation showcase, the Hive, we have observed that healthcare innovators utilize three secret weapons:

• Unprecedented teamwork
The most successful health care innovators usually group up for new ranges of multi-disciplinary and international collaboration. Combining the very best considering of authorities from several fields and nations is how today’s technologists and scientists break down walls amongst professions, make surprising connections and locate breakthrough tips.

• Imagination
In the past, imagination was virtually suspect in translational health care science, which typically focused on incremental improvements, primarily based on established successes of the previous. Today, healthcare science is asking the “what if” and “why cannot we” queries that have driven so a lot progress in other scientific fields (this kind of as physics and astronomy, for instance).

• Capitalism and idealism
Today’s explosion in health care innovation is powered by a new generation of entrepreneurs who pursue a double bottom line. These passionate inventors want to make a profit. But they are equally driven by a burning wish to make the world a greater, healthier place.

This week, as healthcare communicators from close to the world gather in Cannes at the Lions Wellness Festival, we will be presenting some of the most promising health-related innovations:

• The Tremor Spoon from LiftLabs A spoon with a take care of the dimension of an iPod enables individuals with serious Parkinson’s (or other disabilities that result in shaking hands) to feed themselves. The spoon’s take care of is made up of a minicomputer that detects tremor patterns and vibrates the spoon in the opposite way to cancel out the shaking.

• Maji from Fosmo MedThis revolutionary method could save the lives of two.two million youngsters who die every yr from diarrhea-induced dehydration. Maji converts dirty water into a sterile, drinkable resolution with out requiring any energy. It truly is a huge improvement more than existing IV saline bags, which are 99% water, pricey to ship, have a brief shelf life and are prone to leaks.

LiftLabs and Fosmo Med are two examples of the much more than 80 health-related innovators who will be featured at this September’s TedMed in San Francisco and Washington, DC. Yet another is XStat from RevMedx, which enables paramedics to seal deep wounds in just 5 seconds. XStat is a polycarbonate syringe that slides deep into a wound and releases dozens of pill-sized sponges. The sponges expand to stop internal bleeding. They also incorporate a formula that promotes quick clotting and fights infection.

• V.I.S.O.R. (Visual Details Sensor Optical Reflector) from Gizmonyx enables visually impaired folks to sense their atmosphere such as the shapes and colours of objects, and enables them to recognise faces and go through sentences. An Android IOS gadget picks up tonal representations and spoken phrases, translates them into a “sound picture”, and then transmits it to the consumer by means of vibration. This activates otherwise dormant visual cortices of congenitally blind people, creating the eyes and brain to act as they would for healthy vision.

• Q-POC from QuantuMDx is a handheld touchscreen device that puts a health-related lab in your pocket for on-the-go DNA analysis. The consumer puts a bio sample (blood, saliva, and so forth) into a card-kind cartridge and slides it into the unit. Minutes later, Q-POC delivers a molecular diagnosis onscreen. For illustration, “malaria – optimistic” (together with infection species type, resistance information, and a lot more). In remote or struggling communities with limited healthcare accessibility, Q-POC could alert patients to existence-threatening diseases although there is even now time to intervene.

Behind every single of these innovations is a staff of business visionaries, devoted scientists from many diverse disciplines, driven engineers and technological innovation experts. Thanks to imaginative, scalable innovations like these for wellness and medication, the world’s future appears a good deal far more hopeful.

Shirley Bergin is companion and chief operating officer at TedMed. The Lions Overall health Festival takes spot in Cannes on 13 and 14 June.

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How wellness innovations can decrease the burden of an ageing population

Innovations for ailment control

Insecticide-taken care of school uniforms

Children invest most of the day time at school, which is when dengue vectors are most active. As college uniforms are a cultural norm in most creating nations, Annelies Wilder-Smith of Umeå university produced a task to deal with them with the insecticide permethrin. Although nevertheless to be examined under area problems, past studies have verified that sporting permethrin in clothes can reduce biting charges by up to 90%.

SMS for lifestyle

A public-private partnership led by the pharmaceutical business Novartis brings collectively groups from diverse sectors to improve entry to malaria medicines in building nations. It uses mobile phones, SMS messaging and electronic mapping technologies to track weekly stock amounts at thousands of public health facilities in Tanzania, Ghana, Kenya, Cameroon and Democratic Republic of Congo.

Diagnostic check strips for schistosoma

A new gadget has been developed to test schistosoma infections by detecting parasites in urine. Created by Govert van Dam at Leiden University, the urine test gadget is lightweight and more user-friendly than the laboratory gear utilised for the previously widespread Kato-Katz approach, which was a labour intensive approach that relied on having educated technicians, reagents, microscopes and waste-management procedures.

Sent in via e mail from Mark Booth at the Wolfson Analysis Institute for Wellness and Wellbeing, Durham University

Vector detector

College students in India have developed a residence kit to test malaria, dengue and other vector-borne ailments. The kit, named Janch, has four channels linked with a needle. The channels are filled with distinct antigens to check diverse diseases. When a finger is pricked, blood flows into the channels to show the final results with 98% accuracy. The merchandise has not been launched into the market place but, but is being designed with assistance from the Xavier School of Management.

Airport importation danger device

As we travel more, so also do ailments and the insects that spread them. A new interactive internet site exhibits the achievable routes and risks of vector-borne ailments becoming spread from endemic places to airports via flights. The instrument pulls data from international disease risk and vector presence maps, air travel data, flight capability details and international climatic data sets.

Sent in by means of e mail from Zhuojie Huang at the Centre for Infectious Ailment Dynamics, Pennsylvania State University

Non-toxic chagas vaccine

A new therapeutic vaccine for chagas condition is being produced by Sabin Vaccine Institute, the Texas Children’s Hospital Centre for Vaccine Advancement and a consortium of Mexican institutions. The vaccine can be utilised to both replace existing medicines which are highly toxic or have restricted effectiveness, or collectively with the medicines to lessen treatment length or toxicity. It can be administered by injection to the two youngsters and grownups.

Send in via email by Peter Hotez, president of Sabin Vaccine Institute

Innovations for ailment control

Can open information enhance GPs" consider-up of innovations?

Open information gives a more quickly and less complicated way to see when, in which and which innovations are taken up by GP practices. Photograph: Customized Health-related Stock Photo/Alamy

When we think about innovation, we tend to focus on producing and building new tips, equipment and ways of performing items. Even though useful, this alone it is not ample. To have influence, promising and verified innovations need to be explored and implemented. But how can we motivate GPs to get concerned ?

It has been 3 many years since the NHS announced its intention to prioritise and accelerate the adoption of innovations in their Innovation Overall health and Wealth report and we have noticed some promising measures in the correct direction.

Good not too long ago exposed its Medtech Innovation Briefings and NHS England launched an Innovation Fellowship and a Regional Innovation Fund. This is a excellent commence, but the NHS is even now branded by a lot of as a latecomer.

It truly is no secret that the planet has woken up to the revolutionary possible of using data in the NHS and public companies far more normally. Whether or not large, open or personalized, data can now support us predict patient readmission to hospital and recognize prospective expense financial savings for GP prescriptions. So how are these innovations impacting in our GP practices?

Nesta has worked with the centre for the advancement of sustainable medical innovation and Mastodon C to understand much more about the consider up of innovations by GP practices in England. Our starting up level was the assumption that open information – data created freely obtainable to anyone – can aid us to much better realize what is currently taking spot.

In our new report Which Medical doctors Get up Promising Ideas? New Insights from Open Information, we needed to discover how generating use of open information can aid folks understand trends and differences in service inside main care. Our study charts exactly where, when and which GP practices across England have implemented promising innovations. It shows varied uptake of specific established medicines, technologies and practices by GP surgeries.

The findings are exploratory but promising. They highlight a number of trends around how GP practices determine, make a decision on and actually get up various innovations.

GPs depend on a selection of sources to identify and learn about innovations – including informal local networks, private relationships, and national advice. In particular, fellow GPs and national advice have been influential sources of data.

Although all GP practices have the likely to turn into early adopters of innovations, greater practices had been in a better position to investigate and introduce new innovations, and neighbouring practices tended to have comparable rates and patterns of adopting new innovations.

Equally, handful of are serial early adopters of the innovations we reviewed. As an alternative, we noticed clusters of early adopters about various sorts of innovations (this kind of as technophile practices).

Analysing open data, provides us with a quicker and simpler way to see when, exactly where and which innovations are taken up by GP practices. We still need to contextualise this details to comprehend how and why innovations are taken by distinct GP practices. Nevertheless, as open information grows and becomes a lot more readily offered, it would be a missed chance to not consider how its analysis can be applied to inform and enhance principal care.

There are great possibilities for open information evaluation to inform patient and practitioner priorities and alternatives – and in the long run increase our well being technique.

Local intermediaries, like the academic health science networks and clinical commissioning groups, have a great possibility to prioritise early adoption of innovation, and make use of this data to realize and determine differences in the amounts of engagement within their jurisdictions.

Equally, as wellness turns into more and more people-powered, this kind of details can be employed to carry collectively patients and practitioners into discussions all around revolutionary remedies and wider modifications.

Utilizing open information to realize the take up of innovations is not with no challenges. However, such examination can aid us to quickly comprehend what is happening and recognize trends. Alternatively of ruling out this strategy fully, now is the time to discover and experiment with how this info can be applied to support us increase, adapt and adjust.

Kathleen Stokes is a senior researcher at Nesta and one particular of the authors of Nesta’s new report

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Can open information enhance GPs" consider-up of innovations?