Bridging Aging and Disability Networks: "Strategies for Translating Knowledge into Practice" Luis Salvador-Carulla MD, PhD

A number of questions – –What is the context? – –What is the challenge? – –What is the alternatives? – – What are the main components? – – What are the examples?

Advances in the XXI Century Ageing as an opportunity Ageing as an opportunity – New models of ageing Active ageing, Promotion, Mental capital Active ageing, Promotion, Mental capital –New services and care systems – Supports and HTs for ageing Add case of the painter with down syndrome & Parada Disability as an advantage New models of disability (ICF) New models of disability (ICF) Social Inclusion, Person centred care Social Inclusion, Person centred care Empowerement and Recovery Empowerement and Recovery Accesibility and Employment Accesibility and Employment Supports and HTs for disabilities Supports and HTs for disabilities

C&S in the era of complexity Health promotionHealth promotion Integrative / holistic careIntegrative / holistic care Life-span approachLife-span approach Person-centred carePerson-centred care RecoveryRecovery UniversalityUniversality Mental capitalMental capital

Integrative care model: 10 priority areas Pre-disease pathways- Life-span Positive psychology- Health promotion Genetics - Behavioural phenotypes Personal links- Risks and outcomes Healthy communities Inequities- Context / environment People’s health Effective interventions- Routine practice New methods- Analysis of complexity Infrastructure- Costs and health policy

MENTAL CAPITAL THROUGH THE LIFE COURSE: Flourishing through life / Early detect. & tx. / Chronic conditions

What is the challenge? – –We need to know more about the link D&A Persons with disabilities who grow old Older persons who become disabled – – AGEING as a field has a lot to contribute to the field of DISABILITY and viceversa – – AGEING AND DISABILITY share common values, models, needs and priorities Common policy agenda (implicit – hidden)

Can we understand disability without ageing? Can we understand ageing without disability’

In the D&A fields, their agents and principals do not talk to each other and, when they talk they do not communicate “If the word ‘X’ is used I will leave this table...” “Your model is not acceptable for us...”

D&A Gap: Unwanted consequences Functional Dependency EU Recommendation and related Dependency laws were based exclusively on Ageing and failed to provide effective coverage for SMI, ID and other Disabilities in Europe UN Convention for Persons with Disabilities is seen as ‘alien’ by the ageing sector Missing opportunities of knowlegde, innovation and policy change

Ejemplos Similar programs without any transfer…

Paradigm shift in health/social policy 1. Lavis et al, Health Research Policy and Systems 2009 (SUPPORT MODEL ) 2. Gibert et al, Health Research Policy and Systems 2010 (EbCA MODEL)

A number of questions – –What is the context? – –What is the challenge? – –What is the alternative? – – What are the main components? – – What are the examples?

Health vs Social care Disabilities vs Ageing Translational research Multidisciplinarity

Barcelona 5 – 7 March 2009

BARCELONA DECLARATION Bridging knowledge in Long Term Care and Support Bridging knowledge in Long Term Care and Support Political stand to make bridging and knowledge transfer key components of any program in the fields of disability and ageing.Political stand to make bridging and knowledge transfer key components of any program in the fields of disability and ageing. Need for action involving policy makers and stakeholders, including those from the health, education, social and justice sectors, social partners, as well as civil society organisations.Need for action involving policy makers and stakeholders, including those from the health, education, social and justice sectors, social partners, as well as civil society organisations. Improve the knowledge baseImprove the knowledge base Previous declarations and principles of “Nothing about us without us” and the “World and society of all ages”.Previous declarations and principles of “Nothing about us without us” and the “World and society of all ages”.

Where next?

A&D: Knowledge transfer - WHAT KNOWLEDGE? - HOW SHOULD IT BE TRANSFERRED? - WHO TRANSFERS IT?

BRIDGING & KNOWLEDGE TRANSFER – –B/KT is a construct with two main domains Bridging cannot be made without KT KT cannot be made without bridging – –Tension between perspectives Broad perspective without content High content without generalisability – –B/KT has both general aspects and specific aspects in D&A fields

What is B/KT? – –B/KT is a meta-discipline, a social net & space, a tool for innovation Translational Multidisciplinary Complex Dynamic – –The value of a B/KT scientific road map is very limited but also necessary

B/KT scientific road map Framework model and conceptual map Knowledge base Usability & implementation Monitoring and evaluation Methods of design and analysis Procedures and best practice sets Dissemination strategies Training Support and care policy & priority setting

What knowledge & disciplines? Practical vs semantical knowledgePractical vs semantical knowledge Economics, Ethics, Legal, Technological, Business... Economics, Ethics, Legal, Technological, Business... Health Ontology Explicit formal specification of :Health Ontology Explicit formal specification of : – Representation of health related objects, concepts and other entities which it is assumed that exist in a given field of interest – Properties characterising these entities – Relationship between different entities

Mental Retardation to Intellectual Disab.: Disabilities or Disorders? Salvador-Carulla & Bertelli, 2008

Intellectual Developmental Disorder (IDD) A GROUP OF DEVELOPMENTAL CONDITIONS CHARACTERIZED BY A EXTENSIVE IMPAIRMENT OF COGNITIVE FUNCTIONS, WHICH ARE ASSOCIATED WITH LIMITATIONS OF LEARNING, ADAPTIVE BEHAVIOR AND SKILLS. SYNSET: IDD / ID / MR / LD SYNSET: IDD / ID / MR / LD

Polynomious-polysemic approach IDD ID Salvador-Carulla et al, World Psychiatry, 2011 Health / Statistics / Research / Policy / Social Inclusion / Rights

What is a Hospital?

HOSPITAL – RESIDENTIAL CARE Large variability in availability of ‘hospital non-acute care’ with lowest level in Andalucia and highest in Catalonia

HOW TO TRANSFER KNOWLEDGE? - - New organisation-relational strategies - New research strategies Impact analysis Knowledge Discovery from Data Expert-based Cooperative Analysis - New implementation strategies - New dissemination strategies

WHO TRANSFERS THE KNOWLEDGE? - - Health knowledge brokers - Champions - Interpreneurs - Intra-Interpreneurs

Harvard School of Engineering and Applied Science – Cuisine and Science Ferran Adria Ferran Adria

The new model of society demands us to share our knowledge with others. If you are a millionaire you should share your money, if you are ‘creative’ share your ideas. In the global society those who refuse to share there knowledge are socially dead The new model of society demands us to share our knowledge with others. If you are a millionaire you should share your money, if you are ‘creative’ share your ideas. In the global society those who refuse to share there knowledge are socially dead Ferran Adria