BRIDGING WELCOME - webgate.ec.europa.eu · BRIDGING KNOWLEDGE WELCOME In recent years, society has evolved and moved forward with regards to sci-entific, technical, health and social

BRIDGING KNOWLEDGE

WELCOME

In recent years, society has evolved and moved forward with regards to sci-entific, technical, health and social aspects. The said advances have translat-ed into various organizational and interactive aspects in the social, political, economic, demographic, and biological spheres among others.

However, there are still important challenges to be met, in particular one of a constant and permanent nature, as is the care of people from a global point of view, focusing on the need to offer human and humanizing care.

Social care still is a current affair. Whilst people are referred to in a compart-mented fashion so as to facilitate the understanding of our environment, the response to their needs must be of a global and holistic nature. Because of this reason, it is difficult to understand the response to health and medical needs without taking into account the social, economic and environmental aspects of people. Still today, the health care and social care frameworks ap-pear to be too distant one from another.

Obra Social de Caixa Catalunya wants to contribute to a discussion to put forward recommendations in order to integrate both health care and social care activities taking into account the individual as a whole. Not only this, we aim to facilitate the knowledge transfer across the various fields of action.

Because of this, and with the collaboration of European organizations like the London School of Economics, the EASPD Association, the AGE Platform, the University of Vienna and PSICOST and the support of the European Union (EAHC), the Spanish Ministry of Health and Consumer Affairs and the Generalitat de Catalunya, Obra Social de Caixa Catalunya has organized this International Conference on Bridging Knowledge in the domains of senior and disabled people.

We are convinced that all participants will bring the best of their experi-ence and that we will all learn from each other, leaving Barcelona with a larger knowledge and new ideas to find better ways to provide care to the people.

Miquel PerdiguerDirector, Obra Social de Caixa Catalunya

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PRESENTATION

BRIDGING KNOWLEDGE

DEAR COLLEAGUES During the next years over 15 million persons with disabilities will enter old age; and a similar number of elderly people will become disabled. Links do exists between both groups and experiences may be shared in a broad range of topics, from concepts and values to the assessment and meeting of needs, or the development of tools for evidence based policy in both areas. Bridges have always existed across the two fields of disabilities and ageing, but they have been limited, and they coexist with significant barriers to communication and information sharing. Although health and social care providers have been encouraged to work in partnership and build interdis-ciplinary teams, the success of this approach has been limited.

New notions such as “networks”, “knowledge brokering” and partnerships have entered this discourse but the lack of consensus and understanding about what they mean and how to implement it limits its use in the care sector. The health sector has already developed strategies for knowledge brokering, translational exchange of experiences and integrated care, while the social sector has developed the conceptual background in the areas of functioning, social inclusion and cohesion.

On the other hand, a series of key international documents have provided a new perspective on care and support for persons with disabilities and the elderly (i.e. Graz Declaration on Disability and Ageing, the UN Convention on Disabilities, several international documents on ageing and the EU rec-ommendation on care for dependent population in Europe). Both topics have shifted from marginal areas of health and social care to a central posi-tion in support and care delivery in Europe. There are a number of key and common topics across these fields that de-serve international interest. For example, the existing difference between the concepts of dependency, independency and interdependency; the best way to develop and to implement a holistic integrative care/support; or the procedures and experiences in transdisciplinarity, and in the development of multidisciplinary groups in management, research and education. Being a transrelational concept, bridging is not an endpoint, but a tool for reach-ing an integrative care and support.

I welcome you to Barcelona and to bridge knowledge and experience in long term care and support.

Luis Salvador-CarullaConference Chair

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A balanced perspective cannot be acquired by studying disciplines in pieces;

the consilience among them must be pursued. Such unification will be dif-

ficult to achieve. But I think it is inevitable. Intellectually it rings true, and it

gratifies impulses that arise from the admirable side of human nature.

To the extent that the gaps between the great branches of learning can be

narrowed, diversity and depth of knowledge will increase.

E. O. Wilson

“Back from chaos”, The Atlantic

Monthly, March 1998, 281(3): 62

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BRIDGING KNOWLEDGE

The “1st International Conference on Bridging Knowledge in Long Term Care and Support. Crossing Boundaries between Ageing and Disabilities” is under the patronage of the Executive Agency for Health and Consumers of the European Commission (Project number: 101278).

This Conference is organised by the Obra Social Caixa Catalunya with the collaboration of:

> AGE – the European Older People´s Platform> European Association of Service Providers for Persons with Disabilities (EASPD)> London School of Economics and Political Science> University of Vienna> PSICOST Scientific Association> Department of Health of the Generalitat de Catalunya> Ministry of Health and Consumers of Spain

CONFERENCE ORGANISATION

Luis Salvador-CarullaConference Chair Asociación Científica PSICOST Spain

Jordi BalotFundació Caixa CatalunyaSpain

Murielle BendeckScientifi c Programme SecretariatINGENIS Consulting GroupSpain

Mònica DuaigüesFundació Caixa CatalunyaSpain

Martin KnappLondon School of Economics and Political ScienceUnited Kingdom

David McDaidLondon School of Economics and Political ScienceUnited Kingdom

Anne-Sophie ParentAGE - the European Older People’s Platform Belgium

Josep SolansFundació Caixa CatalunyaSpain

Germain WeberUniversity of ViennaAustria

Luk ZelderlooEASPDBelgium

CONFERENCE COMMITTEE

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BRIDGING KNOWLEDGE

PAGE 01 WELCOME

PAGE 02 PRESENTATION

PAGE 05 CONFERENCE ORGANISATION

PAGE 74 LIST OF PARTICIPANTS

PAGE 14 ABSTRACTS

PAGE 08 PROGRAMME

PAGE 80 INDEX

Technical Secretariat:

[email protected]

TABLE OF CONTENTS>

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BRIDGING KNOWLEDGE

PROGRAMMEThursday, March 5th < Bridging disciplines

Opening

Narcís SerraPresident. Caixa Catalunya

Honorable Sra. Marina GeliConsellera de Salut. Generalitat de Catalunya

Honorable Sra. Carme Capdevila*Consellera de Acció Social i Ciutadania. Generalitat de Catalunya

Pablo Rivero CorteDirector General de la Agencia de Calidad del Sistema Nacional de Salud. Ministerio de Sani-dad y Consumo (España)

Stefan SchreckHead. Health Programme Unit. Executive Agency for Health and Consumers (EAHC). European Commission

Luis Salvador-CarullaPresident. Asociación Científi ca PSICOST (Spain)

09.00AUDITORI CAIXA CATALUNYA

08.00

Keynote 1. Crossing network lines between ageing and disabilities

Michelle Putnam. Simmons College School of Social Work

Chair: Luis Salvador-Carulla. PSICOST Research Association

11.00 - 11.30

11.30 - 12.00

Coffee Break

09.45 -11.00Special Symposium A: Perspectives of the European institutions on bridging

Chair: Stefan Schreck. EAHC, European Commission

Johan Ten Geuzendam Unit “Integration of People with Disabilities”DG for Employment, Social Affairs and Equal OpportunitiesEuropean Commission

Council of Europe actions to promote the rights and full inclusion of ageing people with disabilitiesAngela GarabagiuCouncil of Europe

The Commission strategy for supporting the quality of Social Services of General Interest across the European Union Concetta CultreraUnit “Social Protection, Social Services”DG for Employment, Social Affairs and Equal OpportunitiesEuropean Commission

Conference Registration

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Special Symposium B: International perspectives on bridging knowledge

Chair: Enric Mayolas. Departament de Salut, Generalitat de Catalunya

Partnering the aging and disabilities systems: the USA experienceMatthew Janicki

The MHADIE project: a European experience on bridging in disabilitiesJosé Luis Ayuso-Mateos

Status of elders with and without disabilities and their services in United Arab Emirates Abedalaziz Abedalmoti

13.00 - 14.30 Lunch break

14.30 - 15.50

PARALLEL SYMPOSIA

AUDITORI CAIXA CATALUNYAKEY CONCEPTS AND TOOLS FOR BRIDGING

SALA GAUDI TRAINING AND DISSEMINATION

Symposium 1. Bridging Key Concepts in Dis-abilities and Ageing

Chair: Antoni Bulbena

Defi ning disability and re-defi ning policy Matilde Leonardi

The concept of “functional dependency”Luis Salvador-Carulla

Autonomy and interdependencyLuk Zelderloo

Symposium 3. Dissemination and Knowledge Transfer

Chair: Britt Venner

Transfer knowledge for younger generations Josep Solans

Incorporating bridging to scientifi c literature Guus Schrijvers

Transferring research to policy and practice: quo vadis?David McDaid

17.40 - 18.30Keynote 2. Population development and the need for housing for elderly people in Sweden

Barbro Westerholm. Swedish Parliament and Health Group (AGE)

Chair: Luk Zelderloo. EASPD

AUDITORI CAIXA CATALUNYA

15.50 - 16.20

16.20 - 17.40Symposium 2. Conceptual Tools for Building Bridges in Ageing and Disabilities

Chair: Lilijana Sprah

Semantic interoperability - Role and operational-ization of the ICFNenad Kostanjsek

Relational strategies for bridging and promot-ing cross-sector collaboration Xavier Mendoza

Integrated care and disease management as a bridge in ageing and disabilitiesGuus Schrijvers

Symposium 4. Bridging Education and Train-ing in Ageing and Disability

Chair: Mojca Dernovsek

Bridging education and training in ageing and disabilities: Towards translational educationDieter Ferring

Basic European Social Care Learning Out-comes James Churchill

Bridging the fi elds of disability and ageing: the Graz Declaration on Disability and AgeingGermain Weber

Coffee Break

12.00 - 13.00

BRIDGING KNOWLEDGE

PROGRAMMEFriday, March 6th < From research to society

09.00 - 09.50AUDITORI CAIXA CATALUNYA

Keynote 3. Professional perspectives on bridging: the person-centred approach

Juan Enrique Mezzich. Mount Sinai School of Medicine

Chair: Matthew Janicki. University of Illinois at Chicago

10.00 - 11.20

PARALLEL SYMPOSIA

AUDITORI CAIXA CATALUNYABRIDGING RESEARCH AND PRACTICE TO SOCIETY

SALA GAUDI RESEARCH STRATEGIES FOR BRIDGING

Symposium 5. Regional and National Experi-ences on Bridging(In cooperation with the eDESDE-LTC group)

Chair: Juan Cabasés

Local, regional and national experiences on bridging: US perspectives Michelle Putnam

Regional and national experiences on bridging: a Western European perspectiveDavid McDaid

Bridging the breach in services for ageing people with disabilities in BulgariaHristo Dimitrov

Strategy for care for the elderly persons in Slo-veniaMojca Dernovsek and Lilijana Sprah

Symposium 9. Outcome Measures and Health Indicators in Disabilities and Ageing

Chair: Antoni Salvà

Translational measures of functioning and dis-ability based on the ICFAlarcos Cieza

Measuring social care outcomesAnn Netten

Health indicators for persons with intellectual disabilities in EuropePatricia N. Walsh

11.20 - 11.40 Coffee Break11.40 - 13.00

Symposium 6. Bridging Experience and Knowledge Across Different Stakeholders I

Chair: Maria Luisa de la Puente

Private stakeholders and providers: the experi-ence of Edad&Vida FoundationHiginio Raventós

Institutional sources of trust in government con-tracting in Spain Angel Saz-Carranza

Experiences from research agenciesBritt Venner

Symposium 10. Bridging Services and Care in Europe(In cooperation with the eDESDE-LTC group)

Chair: Angela Rincón

Balance of care: deinstitutionalisation in Europe (MHEEN) Helena Medeiros

Residential services in Europe – fi ndings from the DECLOC studyJulie Beadle-Brown

Coding services for ageing and disability: eDESDE-LTCLuis Salvador-Carulla.

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13.00 - 14.30 Lunch Break

14.30 - 15.50Symposium 7. Bridging Experience and Knowledge Across Different Stakeholders II

Chair: Germain Weber

Experiences from private funding sources in Spain Miquel Perdiguer

Experiences from private funding sources: AustriaFranz Karl Prüller

Experiences from regional public funding agenciesFederico Alonso-Trujillo

Bridging from research evidence to health pol-icy to clinical practice: the case of the Spanish Strategy for Mental Health Manuel Gómez-Beneyto

Symposium 11. Methods and Tools for Bridg-ing Analysis

Chair: Giuseppe Tibaldi

Qualitative and quantitative research methodsMaria Luisa Vázquez

Benchmarking and DEA: relative technical ef-fi ciency models Carlos García-Alonso

Knowledge Discovery from Data as a frame-work to decision support in medical domainsKarina Gibert

16.20 - 17.40

15.50 - 16.20 Coffee Break

Symposium 8. Bridging Experience and Knowledge Across Different Stakeholders III

Chair: Hristo Dimitrov

The role of providersFranz Wolfmayr and Luk Zelderloo

The role of users and providersElizabeth Mestheneos

Disability, UN Convention and human rightsMatilde Leonardi

Symposium 12. Accessibility, Technology and Bridging

Chair: Cristina Molina

Usability of assistive technologies in ageing and disabilitiesClaudia Oppenauer

Accessibility and assistive products Cristina Rodríguez-Porrero

Information and communication technology in learning development and rehabilitation José María Tormos

17.40 - 18.30Keynote 4. Economics and new strategies for funding and fi nancing: Towards a new science of bridging?

Juan Cabasés. Universidad Pública de Navarra

Martin Knapp. London School of Economics and King’s College London

Chair: Massimo Moscarelli. International Center of Mental Health Policy and Economics

AUDITORI CAIXA CATALUNYA

AUDITORI CAIXA CATALUNYABRIDGING RESEARCH AND PRACTICE TO SOCIETY

SALA GAUDI RESEARCH STRATEGIES FOR BRIDGING

BRIDGING KNOWLEDGE

PROGRAMMESaturday, March 7th < Bridging policy and society

Keynote 5. Beyond classifi cations: entities of knowledge exchange

Bedirhan Üstün and Nenad Konstanjsek. World Health Organization

Chair: Manuel Palomar.Universidad de Alicante

09.00 - 09.45AUDITORI CAIXA CATALUNYA

09.45 - 10.55Special Symposium C. Perspectives on bridging and policy

Chair: Josep Ramos. Sant Joan de Déu – Mental Health Services

Inclusion and Community: the work of a cross-sectoral UK programme to deliver inclusion policy David Morris. University of Central Lancashire

Bridging policies and practice: Challenges and opportunities for the governance of disability and ageingUrsula Naue. University of Vienna

10.55 - 11.25 Coffee Break

11.25 - 12.10Keynote 6. From research to policy and from policy to society: the age friendly programmes

Alexandre Kalache. New York Academy of Medicine

Chair: Elizabeth Mestheneos. AGE Platform

12.45 - 13.00Fundació Caixa Catalunya Award “Bridging Knowledge in Long Term Care”

13.00Closing

Miquel PerdiguerDirector. Obra Social Caixa Catalunya

Elizabeth MestheneosPresident. AGE – the European Older People’s Platform

Franz WolfmayrPresident. European Association of Service Providers for Persons with Disabilities (EASPD)

Martin KnappProfessor. London School of Economics and King’s College London

Germain WeberProfessor. University of Vienna

12.10 - 12.45Bridging Knowledge Rapporteur Summary

- General issues:- Methods: - Policies:

David McDaid (Coordinator). London School of EconomicsAlarcos Cieza. Ludwig Maximilian UniversityAna Rico. Instituto Carlos III

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POSTER PRESENTATIONS

EURHOMAP: Mapping professional home care in EuropeMarta Cabanas

Long term care at night: understanding sleep in care homesIngrid Eyers

Life-expectancy in disability and in self-reported health status are connectedMontserrat Guillén

Knowledge Discovery from Data and Monte-Carlo DEA to evaluate technical effi ciency of mental health care in small health areasLeonor Pérez-Naranjo

Comparative study of mental health services availability and use in Chile and SpainCristina Romero

Implementation of the Dependency Law in Spain. The activities based cost systems as tools that can facilitate decision-making for the implementation of the LawMercedes Ruiz Lozano

The well-being of Iranian mothers and fathers who have children with developmental disabilitiesSayyed Ali Samadi

Chronic Conditions Management Model (CCMM) for primary care in the U.K.Urvashi Sharma

Posters will be displayed during conference hours on Thursday and Friday. Poster presenters will be available for discussion during the scheduled coffee breaks.

(*) To be confi rmed

BRIDGING KNOWLEDGE

BRIDGING DISCIPLINES

Conference abstractStatus of elders with and without disabilities and their services in United Arab Emirates

Abedalaziz Abedalmoti, Chairman and professor, Special Education Department, United Arab Emirates University, United Arab Emirates (UAE)

Correspondence to: Abedalaziz Abedalmoti, E-mail: [email protected]

Introduction: In the light of developing the level of health care services in the world, taking care of elderly people in general has taken great deal of emphasis since the second half of 20th century.

Context: Due to surplus of oil revenues, GCC countries have witnessed dur-ing the last four decades a rapid economic, social and cultural transfor-mational movement which produced comprehensive and developmental programs in all aspects. It is quite notable that the economic growth in GCC countries was parallel with health, social, educational and cultural growth reflected in the concepts dealing with most needy groups of society such as children, handicapped and elders. Small and the large family in the United Arab Emirates (UAE) society have always been the safe haven to all its mem-bers from children to elderly stage. Since the UAE society pays a special trib-ute to elderly people being the men of yesterday and wise men of today, the elderly people have occupied a special place in social services policies implemented by UAE government since its establishment in 1971.

Aims: The purpose of this paper is to overview the current services of el-derly people especially those with handicapping conditions in UAE society. Analysis of social, economical and cultural background is taken into consid-eration when providing appropriate suggestions and recommendations to enhance and promote elderly programs.

Keywordselderly population, disabilities, health care services, United Arab Emirates

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FROM RESEARCH TO SOCIETY

Conference abstractExperiences from regional public funding agencies

Federico Alonso-Trujillo, MD, Ph.D., AECES – Asociación Española para el Estudio Científi co del Envejecimiento Saludable, Antequera (Málaga), España

Correspondence to: Federico Alonso-Trujillo, E-mail: [email protected]

Introduction: There is an increasing demand of social and health services by persons with long term care (LTC) needs. On the other hand the de-volution process has shifted governance and funding to regional agencies in many EU countries. Regional agencies are getting an increasing role in funding LTC. Knowledge transfer (KT) plays a key role in the development of regional funding agencies, as they should cooperate with both local and national agencies as well as several European organisations and companies operating in their regions. The communication barriers between social and health services play a particular role at regional level.

Description of care or policy practice: In Spain the 17 regions have full gov-ernment autonomy in health and social care. These regions have devel-oped different approaches to coordination of care and KT. Andalusia is the larger region in Spain. In order to coordinate provision and planning, the regional government has developed a network of cross-sectional agencies in specific areas such as Mental Health (FAISEM), Social Services in Ageing, Disabilities, Poverty and TICs (FASS), Emergency care (EPES), care related to gender (Instituto Andaluz de la Mujer), Health Care for the Elderly in the community (Living Lab and IAVANTE Foundation) or innovation in new technologies applied to social care (I2BC); among several others. A number of these public organisations are privately run.

Discussion: Coordination and links across these organisations as well as funding issues are discussed here. The relationship or coordination agencies with citizens and other stakeholders deserve special attention as well. An-dalusia provides an interesting case of cross-sectorial coordination within the European context.

Keywords knowledge transfer, social and health services, e-services, funding agencies, long term care and support, assisting living services, effi ciency, dependence, elderly people, persons with disabilities

BRIDGING KNOWLEDGE


Conference abstractThe MHADIE project: a European experience on bridging in disabilities

José Luis Ayuso-Mateos, M.D., Professor of Psychiatry, Chairman Department of Psy-chiatry, Medical School, Universidad Autónoma de Madrid, Spain

Correspondence to: José Luis Ayuso-M., E-mail: [email protected]

The Measuring Health and Disability in Europe (MHADIE) was funded as part of the 6th Framework Programme by the European Commission to be developed between 2005 and 2008. The main aim of the project was to demonstrate the feasibility and utility of the World Health Organisation’s International Classification of Functioning, Disability and Health (ICF) as a cross-cutting, universal framework and international standard to influence and support new European policy guidelines on health and disability by means of statistical, clinical and experimental research. ICF’s universal ap-proach constitutes a paradigm shift in our understanding of disability, one that underscores the need to integrate individual functioning with the com-plete physical and social environment in order to capture the full lived ex-perience of disability that links health and social policy to promote social integration and increase participation, thereby enhancing opportunities for persons with disabilities.

As part of this Co-ordination Action institutions and researchers from 11 countries distributed across all the European Union have been able to dem-onstrate the application of the ICF model in the collection of health and disability data using this common framework The project has established a network of European partners that are involved at regional, national and international level with the implementation of ICF, ICF children version and ICF related instruments in clinical samples of selected conditions.

Specifically, this Co-ordination Action has been able to:1) employ the ICF model of functioning and disability to analyse existing general population health surveys and education statistics data; 2) demonstrate that the ICF model is adequate for describing and measur-ing patterns of disability in clinical samples of selected conditions, cross-sectionally and over time; and 3) demonstrate the feasibility and usefulness of the ICF for collecting and managing data in educational sectors.

Among the results, MHADIE partners have produced specific policy recom-mendations and guidelines designed for use in health disability policy plan-ning and development across the European Union.

KeywordsMHADIE project, bridging, disabilities

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Conference abstractResidential services in Europe – fi ndings from the DECLOC study

Julie Beadle-Brown, Tizard Centre, University of Kent, Canterbury, United Kingdom Jim Mansell, Tizard Centre, University of Kent, Canterbury, United Kingdom Martin Knapp, PSSRU, London School of Economics, London, United Kingdom Jennifer Beecham, PSSRU, London School of Economics, London, United KingdomThe DECLOC group

Correspondence to: Julie Beadle-Brown, E-mail: [email protected]

Background and aims: This study aimed to collate and summarise statistical information on the number of people with disabilities living in all types of residential care but with a particular focus on those living in institutional care within 28 countries in Europe to analyse the costs and outcomes of the transition to community-based services in order to provide recommenda-tions for agents in these countries to help bring about the change. The ra-tionale for the study was to inform the political debate, to provide evidence and recommendations to support the move to community-based living for people with disabilities. The study aimed to collect data across client groups (intellectual disability, physical and sensory disability and mental illness) and across different age groups (children, adults and older adults).

Description of project: There were 2 phases to this study – the first provided a description of service types in each country and collated existing official statistics on the number of people with disabilities in the different types of residential services; the second phase analysed the existing body of knowl-edge on costs and outcomes of institutional and community based services to provide conclusions and recommendations.

Conclusions: More than 1.45 million people with disabilities in Europe still live in residential care with 70% of these living in services with over 30 places. Data was better on people with intellectual disabilities than for other user groups but figures collated are none-the-less an underestima-tion. Drawing together such a mass of information served to highlight the extent of the work still needed to achieve the UN Convention on the Rights of People with Disabilities in almost all the countries included in terms of community based services for all. It also highlighted the gaps in the avail-able data. Challenges in the task of collating information included the lack of information collated at national level, the issue of varying definitions in use and inconsistency in how and where data was available.

Discussion: Most countries in Europe still have some way to go to be able to meet Article 31 of the UN Convention on the Rights of Persons with Dis-abilities. Recommendations focuses are offered to help bridge the gaps in data available on the situation of people with disabilities.

Keywordsdisabilities, residential care, institutions

BRIDGING KNOWLEDGE


Poster abstractEURHOMAP: Mapping professional home care in Europe

Marta Cabanas, IDIAP Jordi Gol, Barcelona, SpainM Àngels Ondiviela, Institut Català de la Salut, Barcelona, SpainBonaventura Bolibar, IDIAP Jordi Gol, Barcelona, SpainJosé Miguel Morales, Escuela Andaluza de Salud Pública, Granada, SpainFrancisco José Audera, Servicio Aragonés de Salud, Zaragoza, SpainJoana Maria Taltavull, Gerencia de Atención Primaria de Palma de Mallorca, SpainThe EURHOMAP group*

Correspondence to: Marta Cabanas, E-mail: [email protected]

Introduction: Not only is there no comparable information on home care available from the newest EU member states, but information from the other 15 is old. Furthermore, as European countries have implemented health care reforms over the past decade, updating is needed.

Description of policy practice: The EURHOMAP project (Mapping profes-sional home care in Europe) aims to describe and compare the organisation and provision of home care (health and social) services through the gath-ering, analyzing and disseminating of information on various aspects of home care services in 32 European countries.

Discussion/Conclusions: Data collection will be done firstly with vignettes, descriptions of cases of elderly or disabled people in need of care living at home, and secondly with a collection table including data and selected home care items. Both instruments will be handled by experts. Comparison of the two instruments will show the diversity of home care in Europe: different roles of home care in European health care systems, variations in financing and provision, links with other sectors of health care and social services, and type of patient needs and demands to which home care is responding.

Keywords home care services, ageing, health and social policies, organization

EURHOMAP group*: Cabanas M, Ondiviela MA, Bolibar B, Morales JM ,Audera FJ, Taltavull JM, Cegri P, Contel JC, Jimenez EM, Lacasa C, Lopez Y, Nogueras C, Jimenez S, Pujol E, Martin R, Gonzalo E, Martín FJ, Moreno L, Serra S, Blasco I, Genet N, Boerma W, Barcons M

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Conference abstractBasic European Social Care Learning Outcomes

James Churchill, CEO, ARC, Chesterfi eld, EnglandEva Gyorki, CEO, Fundata Alpha Transsylvana, Tirgu Mures, Romania

Correspondence to: James Churchill, E-mail: [email protected]

Introduction: There has been significant movement of workers between EU countries seeking work in the social care sector, causing problems for workers and employers who cannot easily evaluate the worth of qualifica-tions gained abroad. The European Care Certificate (ECC) helps workers start work in the social care sector by defining basic knowledge and offer-ing recognition for their learning.

Development of product: A LEONARDO project involving six countries (BE, UK, AT, DE, RO, PO) established a set of learning outcomes - the BESCLO (Basic European Social Care Learning Outcomes) covering 8 key areas of knowledge (not competence). Existing awards and courses become ‘ECC compliant’ by demonstrating coverage of all the BESCLO. Students pass a multi-choice exam to gain the Certificate. There is a developing system of Lead and Delivery Partners spreading the ECC across Europe.

Conclusion: The BESCLO covers essential knowledge with a common set of values in social care. The ECC fits within existing training courses, is cheap and easy to operate, is at entry level, covers all client groups, can be made available in any language and is equally useful in recruitment, workplace induction training, or more formal college / university courses as an early achievement marker. Website: www.eclicence.eu

Keywordsinduction, training, learning outcomes, social care, ECC

BRIDGING KNOWLEDGE


Conference abstractTranslational measures of functioning and disability based on the ICFAlarcos Cieza, PhD, MPH, Senior Researcher, ICF Research Branch of WHO FIC CC (DIMDI), Institute of Health and Rehabilitation Sciences, Ludwig Maximilian Univer-sity, Munich, Germany

Correspondence to: Alarcos Cieza, E-mail: [email protected]

Introduction: The International Classification of Functioning, Disability and Health (ICF) is the first universally shared model and classification of func-tioning, disability and health. It can be used as an assessment instrument based on ICF-derived tools, such as the ICF Core Sets, as well as a reference for other outcome measures and health indicators.

Aims: To present the results of the development of the Generic ICF Core Set and the results of the comparison of the Generic ICF Core Set and the six widely-used generic outcome measures: the SF-36, the NHP, the QL-I, the WHOQOL-BREF, the WHODASII and the EQ-5D.

Results: The Generic ICF Core Set is a parsimonious set of ICF categories which defines the health and health-related domains to be taken into ac-count to assess health from a comprehensive perspective. It contains all health and health-related domains that are addressed in the most widely-used outcome measures and health indicators.

Conclusions: The consequent use of the Generic ICF Core Set enables the comparison of health information across health conditions and health-care contexts. It also enhances the international comparability of health and functioning and disability data and can ultimately contribute to the improvement of care and support for persons with disabilities and the el-derly.

Keywordsoutcome assessment, health, disability

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Conference abstractThe Commission strategy for supporting the quality of Social Ser-vices of General Interest across the European UnionConcetta Cultrera, Head of Sector, Unit “Social Protection, Social Services”, DG Employment, Social Affairs and Equal Opportunities, European Commission

Correspondence to: Concetta Cultrera, E-mail: [email protected]

Introduction: The announcement of the Commission strategy for support-ing the quality of social services of general interest (SSGI) across the Europe-an Union in the Communication on “services of general interest, including social services of general interest: a new European commitment”.

The reasons for a quality framework: First, when dealing with a variety of providers, public authorities need to clearly define the services they are delegating and thus the quality they expect. Second, societal challenges and changing needs have a direct impact on the demand for SSGI, which has increased and has become more sophisticated. Enhancing SSGI quality and efficiency is essential in order to address this increasingly more sophis-ticated and evolving demand for SSGI and to foster the ability of users to make informed choices. Third, a consistent part of SSGI addresses the (mul-tiple) needs of vulnerable users. A EU Quality framework will enhance their ability to make informed choices, thereby strengthening equitable access to SSGI. Fourth, the expanding and more complex demand for SSGI raises the need for sufficient and well trained human resources. Finally, in the EU context, the debate on SSGI quality and efficiency acquires a special value also because of the cross-border dimension of SSGI provision.

The Commission strategy - three complementary actions: (1) Financing via the PROGRESS programme bottom-up initiatives aimed at developing mech-anisms for the definition, measurement, assessment and improvement of SSGI quality. These initiatives, which have started at the end of 2008, cover a variety of SSGI, such as long-term care services to elderly people, services for the integration of migrants, services to people with disabilities, services to homeless people and childcare services. (2) Financing public authorities training programs, which will notably focus on how to guarantee the deliv-ery of quality services when applying public procurement rules and state aid rules for the selection and the financing of SSGI providers. (3) Supporting the development, within the Social Protection Committee, of a voluntary quality framework for SSGI. This will provide a tool that public authorities and other relevant stakeholders can refer to in order to define, measure and assess SSGI quality and therefore to promote high-quality SSGI.

KeywordsSocial Services of General Interest, European Commission, long term care services, elderly, disabilities, quality

BRIDGING KNOWLEDGE


Conference abstractStrategy for care for the elderly persons in Slovenia

Mojca Zvezdana Dernovšek, PhD, Assistant Professor, Educational and Research Institute Ozara Ljubljana, Ljubljana, SloveniaLilijana Šprah, PhD, Assistant Professor, Sociomedical Institute at Scientifi c Research Centre of the Slovenian Academy of Sciences and Arts, Ljubljana, Slovenia

Correspondence to: Mojca Zvezdana Dernovšek, E-mail: [email protected]

Introduction: The size and age-structure of Europe’s population is undergo-ing dramatic changes due to low fertility rates, continuous increases in life expectancy and the retirement of the baby-boom generation. “The Strat-egy for care for the elderly till 2010 - Solidarity, good intergenerational relations and quality ageing of the population”, prepared by Ministry of Labour, Family and Social Affairs, is the response of the Republic of Slove-nia to the ageing society and to the European demands for new solidarity between the generations. The main purpose of the strategy is to create good conditions for preserving and strengthening solidarity, for good in-tergenerational relations and to ensure quality ageing and care for the fast growing third generation. Special attention is given to the long-term care and the implementation of the new insurance for it.

Description of care: Slovenia was 40 years ago one of the first countries with an efficient gerontological institute. The social welfare system in Slo-venia today is based on the welfare system of public social insurance imple-mented in former Yugoslavia, which for elderly primarily developed nursing homes. Nursing homes in Slovenia are fully occupied at the moment. There are approximately 3.8% of people older than 65 live in nursing homes. The number of applications has been growing and waiting list for a bed to be-come available has been prolonging.

Discussion: Like in other European countries, there are also in Slovenia trends toward developing specific services for the elderly, adjusted to their needs and preferences. However, to a large share of the elderly population these services are not accessible – partly due to their small number and part-ly due to their high price. Furthermore, the majority of the elderly people wish to live in their current dwelling and familiar environment.

Conclusion: In developed societies the quality of life of the elderly popula-tion is coming to the forefront of research, as well as political agendas. This strategy is the only Slovenian document of this kind, in which different min-istries took part in setting goals regarding ageing population. The strategy covers work of the governmental departments of work, employment, social care, health care, education, economy, traffic, science and other relevant areas and the civil society of the Third sector.

Keywordselderly, services, ageing, strategy for long-term care

23


Conference abstractBridging the breach in services for ageing people with disabilities in a country with challenging demographic prognoses

Hristo Dimitrov, Director, Public Health Association, Sofi a, Bulgaria

Correspondence to: Hristo Dimitrov, E-mail: [email protected]

Introduction: The demography of Bulgaria is characterized by a steady trend for a negative natural growth and increase of the relative share of elderly people. This is a challenge to the health and the social systems. So-cial reports point out: a) unsatisfactory pensions, and b) impoverishment of the group of elderly persons above retirement age. In this context a greater number of people with disabilities will reach old age.

Description: Even though in Bulgaria there are no functioning programs specifically targeted to the needs of ageing people with disabilities, pro-grams exist that serve both the “normally ageing” and adults with disabili-ties. Such is the “Social assistant” service package comprising 50 basic main types of care (i.e. help with grooming, shopping) provided in clients’ homes by briefly trained, previously unemployed non-professionals. The program boasts a need-driven, individually tailored approach, and financial sustain-ability. Over the years social assistants have gone through different training modules, none so far targeted to assessment and treatment of problems that emerge with ageing.

Conclusions: Even within a social service system with scarce resources examples can be found of functioning and sustainable social services’ programs that could be easily adapted to the needs of an ageing disabled population.

Discussion: To improve the focus and the efficacy of such programs we need: 1) research of social, health and psychological status of “normally“ ageing population compared to situation of ageing disabled people; 2) Eq-uity policy based on that research; 3) Improving the knowledge of carers as to changes, concomitant with ageing.

Keywordsnational service system, demographic trends, equity

BRIDGING KNOWLEDGE


Poster abstractLong term care at night: understanding sleep in care homes

Ingrid Eyers, Faculty of Health and Medical Sciences, University of Surrey, Guild-ford, Surrey, United KingdomEmma Cope, Faculty of Health and Medical Sciences, University of Surrey, Guild-ford, Surrey, United KingdomTheresa Ellmers, Department of Sociology, University of Surrey, Guildford, Surrey, United KingdomRebekah Luff, Department of Sociology, University of Surrey, Guildford, Surrey, Unit-ed KingdomSara Arber, Department of Sociology, University of Surrey, Guildford, Surrey, United Kingdom

Correspondence to: Ingrid Eyers, Email: [email protected]

Sleep plays a significant role in the lives of older people experiencing insti-tutional long term care. It relates to their well being yet may also indicate a lack of stimulus and motivation to stay alert and participate in everyday life. However, to date the importance of sleep in this context has not been widely addressed.

This research identifies the determinants of poor sleep in care homes as part of a four year New Dynamics of Ageing Collaborative Research Project, SomnIA (Sleep in Ageing), which addresses practice and policy relevant is-sues arising from the nature, impact and management of the sleep-wake balance in later life. Using multi-methods data was collected in ten care homes. Over a two week period, sleep and activity diaries are collected from 140 residents, supported by 275 hours observational studies, and interviews with residents (n=40) and staff (n=78). A conflict between meeting care needs and the facilitation of sleep has been identified and the findings aim to inform the future development of the care home environment and pro-vide an evidence base from which practitioners can reconfigure the delivery of care to enhance the sleep of older people living in care homes.

Keywordssleep, older people, care homes, routines, care giving

25


Conference abstractBridging education and training in ageing and disabilities: Towards translational education

Dieter Ferring, PhD, Professor of Psychology, University of Luxembourg, Walfer-dange, Luxembourg

Correspondence to: Dieter Ferring, E-mail: [email protected]

Introduction: Translational education takes up the notion of integrating basic research and practice out of a cross-disciplinary perspective given that disci-plinary knowledge will no longer be sufficient to account for the complexity of the encountered problem fields. Persons trained in translational education will thus be able to integrate several disciplinary knowledge domains and translate new developments in basic research to their application.

Description of care or policy practice: The concept of translational education has become prominent in medical training and it clearly has implications for the training of care givers given the complexity of the diverse problems as-sociated with care. Care and care giving always imply theory and research from different scientific disciplines; there are medical, legal, sociological, and psychological components of care giving, and care giving also increas-ingly relies on new developments in the domains of technology. In order to keep an integrative view of all these developments and to finally obtain an integrative approach in care, translational education represents an impera-tive task for training carers in the domains of ageing and disabilities.

Conclusion and discussion: Caring for a person – be it formal or informal – always has to rely on a sound basis of knowledge in order to prevent fail-ures as well as feelings of stress and strain. Given that the knowledge base for carers becomes increasingly complex as it is fed by several disciplines as well as societal developments, training and education programmes should realize both a translational approach as well as a lifelong learning perspec-tive. Although much is in favour of such an approach, limits of translational education do exist as well and these comprise mainly the production of a common knowledge across multiple domains for the cost of neglecting in-depth understanding of specific knowledge domains.

Keywordstranslational education, integrative care, ageing, disability

BRIDGING KNOWLEDGE


Conference abstractCouncil of Europe actions to promote the rights and full inclusion of ageing people with disabilities

Angela Garabagiu, Council of Europe, Strasbourg, France

Correspondence to: Angela Garabagiu, E-mail: [email protected]; [email protected]

Introduction: Taking note of the current demographic situation in Europe, immediate action is required to improve the quality of life of ageing people with disabilities and older people who may develop disabilities as they age.

Aims: Present and discuss the Council of Europe Disability Action Plan 2006-2015 [1] and other policy instruments aimed at enabling member states to face the demographic challenges, to meet the needs of ageing people with disabilities, and to promote the rights and full inclusion for all.

Policy: The Council of Europe Committee of Experts on ageing people with disabilities and older people with disabilities analysed the current situation in a number of European countries and produced a report and recommen-dations, covering a wide range of policy areas. The analysis focused on the following frameworks: legal (with special reference to promoting autonomy and independent life), financial (including rights and funding for services, and diversification of sources of finance), participatory (involvement at dif-ferent stages in planning and implementation of policies, programmes and services), operational (covering a range of measures with an emphasis on in-novation and good practice), and individual (including measures to prepare people for change and transition, needs assessment and service planning on an individual basis). The specific recommendations issued by the Committee based on this analysis are being considered for adoption by a 47-member states’ Co-ordination Forum (CAHPAH) at the Council of Europe.

Conclusions: Innovative approaches and co-ordinated action, which can re-spond to specific needs with the aim of enabling ageing people with dis-abilities to remain in their community to the greatest extent possible, are needed. This requires a careful assessment of individual needs and forward planning as well as the availability of adequate services.

Keywordsageing and disability, quality of life, policy frameworks, Disability Action Plan, Coun-cil of Europe

[1] Recommendation Rec(2006)5 of the Committee of Ministers to member states on the Coun-cil of Europe Action Plan to promote the rights and full participation of people with disabilities in society: improving the quality of life of people with disabilities in Europe 2006-2015;http://www.coe.int/t/e/social_cohesion/soc-sp/integration/02_council_of_europe_disability_ac-tion_plan/Council_of_Europe_Disability_Action_Plan.asp#TopOfPage

Website: www.coe.int ; http://www.coe.int/t/dc/files/themes/handicap/default_en.asp

27


Conference abstractBenchmarking and DEA: how to teach to and to learn from relative technical effi ciency models

Carlos R. García-Alonso, PhD, Professor, ETEA Business Administration Faculty, University of Córdoba, Córdoba, Spain

Correspondence to: Carlos R. García-Alonso, E-mail: [email protected]

Introduction: Information transfer is critical in evaluating the efficiency of health and social care systems. Data Envelopment Analysis (DEA) is a useful tool to evaluate technical efficiency when a range of comparable decision making units (DMU) are involved in an uncertain system. DEA models, based on expert knowledge, must be carefully fitted to represent the framework under study.

Theory and methods: We designed a Monte-Carlo DEA model based on adjusted expert knowledge. The model has been applied to the assessment of technical efficiency of Small Mental Health Areas (SMHA), composed by a complex array of social and health services. The DMU’s Input/Output al-gebraic behaviour was adjusted to an Expert-driven Model of Community Care (B-MHCC). A preliminary version of the model has been applied to the assessment of divergent SMHA in Spain and in Chile. The probability of being efficient of 71 SMHA were analysed in Andalusia (Spain) using large health databases.

Results: The model has shown its usability to identify both efficiency and in-efficiency under uncertainty of highly complex DMUs. For all non-efficient SHA, I/O improvements needed to reach efficiency were also evaluated. Re-sults show significant differences between SHA in Andalusia.

Conclusions: Expert-driven Monte-Carlo DEA is a powerful tool to evaluate relative technical efficiency. Algebraic models need to be carefully fitted by expert knowledge and information transfer strategies should be included in model development.

Discussion: Due to the system complexity, there are many SHA that can be considered efficient and many Input/Output profiles can be used for bench-marking.

Keywordsknowledge transfer, data envelopment analysis, effi ciency, Monte-Carlo simulation

BRIDGING KNOWLEDGE


Conference abstractKnowledge Discovery from Data as a framework to decision support in medical domains

Karina Gibert, Department of Statistics and Operations Research and the Knowl-edge Engineering and Machine Learning Group, Universitat Politècnica de Catalu-nya, Barcelona, Spain

Correspondence to: Karina Gibert, E-mail: [email protected]

Introduction: Knowledge Discovery from Data (KDD) is a multidisciplinary discipline which appeared in 1996 for “non trivial identifying of valid, novel, potentially useful, ultimately understandable patterns in data”. Pre-treatment of data and post-processing is as important as the data exploi-tation (Data Mining) itself. Different analysis techniques can be properly combined to produce explicit knowledge from data.

Methods: Hybrid KDD methodologies combining Artificial Intelligence with Statistics and visualization have been used to identify patterns in complex medical phenomena: experts provide prior knowledge (pK); it biases the search of distinguishable groups of homogeneous objects; support-inter-pretation tools (CPG) assisted experts in conceptualization and labelling of discovered patterns, consistently with pK.

Results: Patterns of dependency in mental disabilities supported decision-making on legislation of the Spanish Dependency Law in Catalonia. Re-lationships between type of neurorehabilitation treatment and patterns of response for brain damage are assessed. Patterns of the perceived QOL along time are used in spinal cord lesion to improve social inclusion.

Conclusion: Reality is more and more complex and classical data analyses are not powerful enough to model it. New methodologies are required including multidisciplinariety and stressing on production of understand-able models. Interaction with the experts is critical to generate meaningful results which can really support decision-making. Particularly convenient transferring the pK to the system, as well as interpreting results in close interaction with experts. KDD is a valuable paradigm, particularly when facing very complex domains, not well understood yet, like many medical phenomena.

Acknowledgements: Thanks to Luis Salvador-Carulla for trusting KDD. This research has been partially financed by PRODEP (Generalitat de Catalunya), Institut Guttmann and project TIN2004-01368.

Keywordsknowledge discovery from data, decision support, medical domain

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Conference abstractBridging from research evidence to health policy and from health policy to clinical practice: the case of the Spanish Strategy for Men-tal Health

Manuel Gómez-Beneyto, Professor of Psychiatry and Coordinator of the Spanish NHS Mental Health Strategy, Madrid, Spain

Correspondence to: Manuel Gómez-Beneyto, E-mail: [email protected]

Introduction: In the last 30 years the Spanish NHS has evolved from a tightly centralized structure to seventeen autonomous regional health systems. As a result a number of benefits have been obtained but also important side-effects such as unjustified variation in clinical practice and a substantial loss of equity.

Description: To deal with these unwanted developments the Spanish Inter-territorial Board of the NHS has recently approved and launched several health strategies on priority areas: diabetes, coronary ischemia, palliative care, cancer and mental health. The strategies are based on scientific evi-dence or consensus and they have been agreed on by all the regions. How-ever, the degree of implementation is not as good as expected.

Conclusion: The gaps from research to policy and from policy to practice in the strategy for mental health are identified and potential solutions are discussed.

Keywordsresearch evidence, health policy, clinical practice, mental health

BRIDGING KNOWLEDGE


Poster abstractLife-expectancy in disability and in self-reported health status are connected

Montserrat Guillén, PhD, Professor, RFA-IREA, University of Barcelona, Barcelona, SpainCatalina Bolancé, PhD, Associate professor, RFA-IREA, University of Barcelona, Bar-celona, Spain

Correspondence to: Montserrat Guillén, E-mail: [email protected]

Introduction: Little is known about the relationship between good self-re-ported health and disability in connection with life-expectancy.

Aims and methods: To show empirical evidence of the significant statistical association between self-reported health status and disability using Spanish survey data and to discuss implications for measures of life expectancy.

Results: We model jointly absence of disability and self-reported good-health status correcting for socio-demographic characteristics such as age, gender and years of education. More than 50% of the correlation exist-ing between self-reported health status and disability cannot be explained. The proportion of years lived in disability or in good health with respect to the remaining life expectancy increases with age, but longevity is more re-lated to disability than to self-reported bad-health. Women report to have good–health less frequently than men, while men report disability more frequently. The influence of the number of years of education is similar for both concepts.

Conclusions: Joint factors other than basic socio-demographic indicators induce a significant association between a disability-free status and good self-reported health. Life-expectancy in good self-reported health is longer than life-expectancy in a disability-free condition.

Keywordslongevity, quality of life, statistics of ageing

31


Conference abstractPartnering the aging and disabilities systems - the USA experience

Matthew P. Janicki, Ph.D., Rehabilitation Research and Training Center on Aging and Developmental Disabilities - Lifespan Health and Function, University of Illinois at Chicago, United States

Correspondence to: Matthew P. Janicki, E-mail: [email protected]

Introduction: In the United States, the original Older Americans Act (OAA) created a system of community-based social support services for persons age 60 and older. An updated OAA included provisions for access to these services by persons with intellectual and developmental disabilities (I/DD) and supports for older carers of persons with I/DD. Many state and local initiatives have been initiated for use of the OAA as a means for promoting greater integration of older persons with I/DD into existing community-based social services for the elderly by targeting primarily the nation’s net-work of senior centres and neighbourhood congregate meal sites.

Description: To help these efforts a national training program underwrit-ten by a federal grant was undertaken in which workshops, networking building, and technical assistance efforts were conducted by a team of gov-ernment and university colleagues.

Conclusion: The outcome was an enhanced understanding - among work-ers in community aging programs - of the needs and wants of older people with I/DD, an opening of programs, and greater collaboration on sharing resources and providing supports and services. Although obstacles remain, often linked to enmity toward people with disabilities, unwillingness to share funds and resources, or age-peer ignorance, the initiatives generally have proved to be productive resulting in enhanced social integration and the elimination of barriers to planning cooperative community services.

Keywordsintellectual disabilities, Older Americans Act, collaborative programs, aging people, senior services, social integration

BRIDGING KNOWLEDGE

BRIDGING POLICY AND SOCIETY

Keynote abstractFrom research to policy and from policy to society: the age friendly programmes

Alexandre Kalache, Senior Advisor to the President on Global Ageing, New York Academy of Medicine, United States

Correspondence to: Alexandre Kalache, E-mail: [email protected]

In order to promote the concept that old age is a dynamic stage of one’s life and that it should be regarded as an achievement - and not a disaster -for both, individuals and for societies, the World Health Organization launched in 2002 the Active Ageing Policy Framework in which Active Ageing is de-fined as “the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age”.

Active ageing depends on a variety of influences or determinants that sur-round individuals, families and nations. They include material conditions as well as social factors that affect individual types of behaviour and feelings. All of these factors, and the interactions between them, play an important role in affecting how well individuals age. These determinants - namely: personal; physical environment; social; economic; behavioural and; access to health and social services within a background that emphasizes the im-portance of the cross-cutting influences of culture and gender - have to be understood from a life course perspective that recognizes that older per-sons are not a homogeneous group and that individual diversity increases with age.

Because active ageing is a lifelong process an age-friendly approach is not just “elderly friendly”: it benefits all age groups. From theory to practice the translation of the Active Ageing Framework required ways to demon-strate its applicability on the ground. Accordingly, WHO embarked on two parallel projects which will be described in detail at the Bridging Knowl-edge Conference:

1. Age friendly Primary Health Care (PHC)

The ultimate aim of health and social services should be that individuals can live for as long as possible enjoying the highest possible level of functional capacity for the longest possible period of time in their own communities. For that to happen it is essential to re-think the way Primary Health Care is conceived and delivered worldwide. Population ageing is happening with-in a background of rapid social change, a shift from infectious to chronic diseases and rising health care costs. Yet PHC is by and large not respond-ing to these trends. In response to this, WHO developed over a period of five years a project involving 14 countries focused on how to make Primary Health Care Centres more age friendly. The ultimate aim of this project, de-

33

veloped over three consecutive stages, was to make available worldwide a toolkit on how to make a PHC facility more responsive to ageing. Its specific objectives were: to minimize the barriers to care; to promote age friendly attitudes and services; to ensure comprehensiveness of community based health care services; to increase geriatric knowledge and skills of communi-ty-based health care staff and; to support coordination and linkages with other community-based groups, services, and family.

2. Age friendly cities

The WHO age-friendly cities global project (AFC-GP) was launched in 2005. In March 2006 a core group of cities met in Vancouver to finalize the project protocol and within the next few months WHO and its partners from 33 cit-ies from 22 countries implemented the qualitative research that led to the WHO Age friendly Cities Guide launched in 1 October 2007.

This project was conceived within the context of three major global trends shaping the 21st century: ageing; urbanization and globalization. The world is ageing fast, is increasingly more urbanized and more than ever before boundaries are becoming blurred, the world more globalized. It is also a practical application of the main call from the International Plan of Action of Ageing agreed by all nations at the World Assembly on Ageing, Madrid 2002 requesting “bottom up approaches”. Thus, the project is based on qualitative research asking older people themselves to identify the issues, concerns and recommendations for improving the environment in which they live around eight main domains: 1. outdoor spaces and buildings; 2 transportation; 3. housing; 4. social participation; 5. respect and social inclu-sion; 6 civic participation and employment; 7 communication and informa-tion; and 8. community support and health services.

Details of both projects can be found on: http://www.who.int/ageing/en

Keywordsage-friendly programmes, ageing, research, policy

BRIDGING KNOWLEDGE


Keynote abstractEconomics and new strategies for funding and fi nancing

Martin Knapp, Professor, London School of Economics and King’s College London, United KingdomJuan Cabasés Hita, Professor, Public University of Navarra, Spain

Correspondence to: Martin Knapp and Juan Cabasés, E-mail: [email protected] and [email protected]

Introduction: Decision makers in care and support systems across Europe are increasingly facing up to new economic realities. Most obvious among the forces that are changing the economic context is the ageing of the population, and the associated realisation that today’s arrangements for supporting older people with health and social care needs will probably not be seen as affordable in 20 or 30 years time. Another force for change is that many more people with major disabilities are surviving into old age. At the same time, and a further cause for celebration, older and disabled people today have different expectations, in particular demanding access to the same opportunities as those available to any other citizen. This mani-fests itself in, for example, higher aspirations for participation in further and higher education, for employment, for relationships and family roles, and for control over decisions that affect their daily lives.

Description and discussion: Set in this exciting new context, the aim of this presentation will be to identify the new economic challenges that pervade the fields of ageing and disability, and describe some possible responses, in particular looking to learn from across the broad spectrum of ageing and disability. Among the areas to be considered are: the funding of long-term care and support, and the need to consider radical new arrangements; the promotion of choice and control; the development of inclusive employment strategies; the conceptualisation and assessment of success (‘outcome’) in research; and the creation of an evidence base to support decision mak-ing. In each case, the focus will be on the contributions made by economic insights and analysis.

Keywordseconomics, fi nancing, funding

35


Conference abstractSemantic interoperability - Role and operationalization of the Inter-national Classifi cation of Functioning, Disability and Health (ICF)

Nenad Kostanjsek, Technical Offi cer, Classifi cation, Terminology and Standards Unit, World Health Organization (WHO), Geneva, Switzerland

Correspondence to: Nenad Kostanjsek, E-mail: [email protected]

Introduction: Globalisation and the advances in modern information and communication technologies (ICT) are changing the practice of health care and policy making. In the globalized economies of the 21 century, health systems will have to respond to the need of increasingly mobile citizens, pa-tients and providers. At the same time the increased use of ICT is enabling health systems to systematize, process and integrate multiple data silos from different settings and at various levels. To meet these challenges effectively, the creation of an interoperable, global e-health information infrastructure is critical. Data interoperability within and across heterogeneous health sys-tems, however, is often hampered by differences in terminological incon-sistencies and the lack of a common language, particularly when multiple communities of practice from different countries are involved.

Aims: Discuss the functionality and ontological requirements for ICF in achieving semantic interoperability of e-Health information systems.

Results: Most solution attempts for interoperability to date have only fo-cused on technical exchange of data in common formats. Automated health information exchange and aggregation is a very complex task which de-pends on many crucial prerequisites. The overall architecture of the health information system has to be defined clearly at macro and micro levels in terms of its building blocks and their characteristics. The taxonomic and conceptual features of the ICF make it an important architectural element in the overall design of e-Health information systems. To use the ICF in a digital environment the classification needs to be formalized and modelled using ontological principles and description logic. Ontological modelling is also required for linking assessment instruments and clinical terminologies (e.g. SNOMED) to the ICF.

Conclusions: To achieve semantic interoperability of e-Health systems a carefully elaborated Overall Health Information System Architecture has to be established. As a content standard, the ICF can play a pivotal role for meaningful and automated compilation and exchange of health informa-tion across sectors and levels. In order to fulfil this role a ICF ontology needs to be developed.

Keywordssemantic interoperability, health and disability classifi cation, ontology develop-ment

BRIDGING KNOWLEDGE


Conference abstract Defi ning disability and re-defi ning policy: the policy recommenda-tions of EU-MHADIE project (Measuring Health and Disability in Europe: supporting policy development)

Matilde Leonardi, M.D., Neurology, Disability and Public Health Unit, Scientifi c Di-rectorate – Neurological Institute C. Besta IRCCS Foundation, Milano, Italy; Coordi-nator, EU MHADIE

Correspondence to: Matilde Leonardi, E-mail [email protected]

Introduction: In 2002, an EC study reported that different European coun-tries define disability differently, and this is one of the primary reasons why no common Europe-wide policies on disability exist. The EU-MHADIE proj-ect was funded with the aim of producing recommendations and guide-lines for future common disability policies. The WHO’s ICF classification and its bio-psycho-social model of disability was the theoretical reference to ground existing and survey data on.

Description of care and policy practice: MHADIE project demonstrated the feasibility and utility of the ICF, as a model of disability and functioning, for the harmonisation of data across populations and sectors in Europe, and for the development of realistic, evidence-based and effective social policies for persons with disabilities that will achieve equality of opportunities and full participation, according to the UN Convention on the Rights of Persons with Disabilities.

Discussion: Disability is an ever-changing experience, and so data that rec-ognize its dynamic nature must be gathered, through longitudinal studies that use a consistent definition of disability. The research performed within MHADIE has demonstrated the feasibility, utility and value of ICF Classifi-cation and model in harmonising data across populations and sectors in Europe. MHADIE researchers have demonstrated that it is possible to de-velop realistic, evidence-based and effective social policies for persons with disabilities and that it is essential to share the same disability definition. By providing a common framework for defining and measuring functioning and disability, MHADIE’s results help to improve the accuracy and compa-rability estimates of prevalence of impairments and disability Europe wide. MHADIE results show, among other, that family and transportation policies are key factors for all persons with disabilities, and dedicated European policies are needed to improve and emphasize their role.

Conclusions: A definition of disability underlying ICF’s principles was pro-duced, together with Policy Recommendation divided into Statistical, Clini-cal and Education sections that have been presented at the European Par-liament and are available at www.mhadie.it.

Keywords ICF classifi cation, disability, UN Convention on the Rights of Persons with Disabilities

37


Conference abstractRegional and national experiences on bridging: a Western European perspective

David McDaid, Personal Social Services Research Unit, LSE Health and Social Care and the European Observatory on Health Systems and Policies, London School of Economics and Political Science, London, United Kingdom

Correspondence to: David McDaid, E-mail: [email protected]

This presentation reflects on experience across the pre-2004 European Eco-nomic Area in making use of formal mechanisms to help collate and consider different sources of information in health and social care policy, with a par-ticular focus on the areas of ageing and disability. The structures, capacity and resource requirements of selected mechanisms will be illustrated. The presentation then assesses how, if at all, different approaches adopted in regions and countries have actually been used to help bridge gaps between different stakeholders, in both establishing policy relevant research priori-ties and developing evidence informed policy and practice. Challenges for the future strengthening of capacity as well as potential opportunities for pan-national co-operation will also be considered.

Keywordsknowledge transfer, evidence synthesis, research capacity, Europe

BRIDGING KNOWLEDGE


Conference abstractTransferring research to policy and practice: quo vadis?

David McDaid, Personal Social Services Research Unit, LSE Health and Social Care and the European Observatory on Health Systems and Policies, London School of Economics and Political Science, London, United Kingdom

Correspondence to: David McDaid, E-mail: [email protected]

Introduction: Research findings are of little use if they are not used to help inform the development of policy and practice. A number of studies during the last decade have indicated the continued need to move more towards evidence-informed policy and practice, yet today there remains too little use of a common language or approach between the research and policy communities. Moreover, research that is undertaken may not be timely or relevant to the current policy making context. This presentation therefore will focus on the identification of barriers and facilitators to knowledge transfer to policy and practice, highlighting some examples of how knowl-edge transfer has been achieved.

Methods: A rapid review of literature of methods of knowledge transfer was undertaken to identify state of the art in mechanisms and approaches to bridging the gap between research and policy. Subsequently, selected policy documents and grey literature in the areas of services for older peo-ple and those with disabilities were scrutinised for exemplar mechanisms that have been used to help facilitate knowledge transfer in Europe and elsewhere.

Results: A number of different elements are key to forming successful approaches to knowledge transfer. These include better presentation of research results in brief, clear, everyday language, presenting both the strengths and limitations of different types of research, the organisation of policy dialogues to help bring researchers and policy makers together to determine feasible and policy relevant research questions, the develop-ment of a new cadre of professionals equally comfortable in both the re-search and policy making environments, and the use of formal assessment bodies which synthesise a range of evidence to help inform key policy mak-ing questions.

Discussion: Evidence is not just generated from research: other sources of information include media reports, representations from consumer groups and general public concerns. Knowledge transfer is thus not a linear one-time event; it requires ongoing active dialogue and exchange between re-searchers, policy makers and practitioners. There is potential to replicate existing mechanisms and approaches to help facilitate knowledge transfer across Europe; one key challenge however is to strengthen the capacity not only to conduct, but also to interpret and communicate research findings.

Keywordsknowledge transfer, knowledge broking, policy syntheses, implementation

39


Conference abstractBalance of care (deinstitutionalisation in Europe): Results from the Mental Health Economics European Network (MHEEN)

Martin Knapp, London School of Economics and Political Science, London, United KingdomDavid McDaid, London School of Economics and Political Science, London, United KingdomHelena Medeiros, London School of Economics and Political Science, London, Unit-ed KingdomThe MHEEN Group

Correspondence to: David McDaid, Email: [email protected]

Introduction: Limited research has been undertaken in Europe examining the shift in the balance of care from psychiatric facilities to community/alternative based facilities (deinstitutionalisation). In order to address this gap the Mental Health Economics European Network undertook research across 32 Network countries to explore the extent to which care has shifted, and what challenges and barriers, particularly any economic and organisa-tional ones, exist.

Methods: In order to examine whether the mix of services and support provided across Europe is considered appropriate, a questionnaire was de-veloped to explore the economic barriers and incentives affecting the shift in the balance of care.

Results: Countries are at different stages in the implementation of dein-stitutionalisation. Community care is greatly overstretched in all countries and very limited in others. Many countries still need to make considerable investments in the necessary physical and human resources.

Conclusion: Network countries have and face varied experiences and chal-lenges. There is growing consensus around community care but there is a lack of community services in many countries. Greater investments and political will is needed.

Discussion: Decision makers need to keep in mind the danger of closing beds before community care is fully developed. The closure of an institu-tion is easy; the challenge is to build good community care. Country leaders need to ensure that mental health services are provided through primary care facilities, with appropriate secondary systems, consisting of specialist consultant services, and inpatient specialist care when needed, and that community care is seen as encompassing social care support.

Keywordsmental health, deinstitutionalisation, community care, economics

BRIDGING KNOWLEDGE


Conference abstractRelational strategies for bridging and promoting cross-sector col-laboration

Xavier Mendoza, PhD, Associate Professor, ESADE Business School, Ramon Llull University, Barcelona, Spain

Correspondence to: Xavier Mendoza, E-mail: [email protected]

Introduction: There is a growing consensus that the response to complex and difficult social problems –being the convergence of ageing and disabil-ity one of them– requires public agencies to be prepared to work in part-nership with other public, civil society and business organisations. However, initiatives aimed at promoting health and social care providers working in partnership have had limited success so far.

Aims: To provide an analytical framework to assess the different kinds of organisational strategies to promote cross-sector collaboration.

Results: The paper draws on empirical research studies in the fields of or-ganization theory and public governance. At a macro level, it refers to the changing role of governments in advanced democracies and the emergence of the relational state as a response to the crisis of the welfare state. At a micro level, it discusses the different modes of non-hierarchical coordi-nation between organisations (or horizontal coordination) as well as the different types of partnerships, their governance forms (market, hierarchy or network) and their organisational and institutional implications (e.g. organisational values, resources and capabilities needed, legal framework and incentives for collaboration).

Conclusions: There are significant obstacles and barriers to cross-sector col-laboration which arise from the nature of the different organisations in-volved (policy domain, public or private status, geographical scope of activ-ity, dominant professional group), their endowment in terms of resources and organisational capabilities, and the institutional framework that regu-lates their interplay. There is not such a thing as “one best way” to achieve effective collaboration; instead decision-makers have a range of alterna-tive collaboration arrangements. Hence the importance of making the right choices and designing context-specific relational strategies.

Keywordsrelational strategies, horizontal coordination, cross-sector partnerships, network governance

41


Conference abstractThe role of users and providers: ageing

Elizabeth Mestheneos, President , AGE-Platform, Brussels, Belgium

Correspondence to: Elizabeth Mestheneos, E-mail: [email protected]

AGE Platform, a European Network of 148 older people’s not for profit or-ganizations at national, regional and EU levels, includes both users and ser-vice providers (www.age-platform.org). It is concerned with all policies and practices at EU and national levels affecting older people, including those needing long term care. Human rights and the avoidance of abuse; service adequacy in terms of quality, funding and coverage; adequate support to informal carers, who provide the majority of care, and professionals; and the need to ensure a client centred approach are critical issues for AGE.

Currently AGE is working with 11 partners in a new EU funded Daphne project EUSTaCEA (European Strategy to Combat Elder Abuse against Old-er Women) that aims to develop a methodology to help all relevant ac-tors (public authorities, providers and users groups) to achieve quality LTC services for the elderly and prevent elder abuse, particularly among older women. The project will develop a European Charter and strategy to stop elder abuse based on work nationally with older people’s organizations and stakeholders (e.g. health professionals, police, informal and formal car-ers) as well as recommendations on prevention and the treatment of elder abuse, with a final presentation to EU and national policy makers.

Keywordselder abuse prevention, EU policy

BRIDGING KNOWLEDGE


Keynote abstractProfessional perspectives on bridging: the person-centred approach

Juan Enrique Mezzich, World Psychiatric Association and Mount Sinai School of Medicine, New York University, United States

Correspondence to: Juan E. Mezzich, E-Mail: [email protected]

The increasing need for bridging in the complex and interactive world in which we live is particularly compelling in the case of fields such as aging and disabilities where contextualization and intersectoral collaboration are paramount. Such bridging involves both conceptual (ethical and scientific) formulations and the engagement of real people and groups.

An emerging approach that may be promising at both of these levels is person-centred health care. The goal and focus of care in this approach is the person in context. This involves health care of the person (of the totality of the person’s health, including its ill and positive aspects), health care for the person (aimed not only to the amelioration of symptoms and dysfunc-tions but also to the fulfilment of the person’s life project), health care by the person (with health professionals extending themselves as full human beings, with high ethical aspirations), and health care with the person (in respectful and empowering collaboration with the person presenting for help).

The implementation of such an approach requires the development of rele-vant clinical procedures such as person-centred integrative diagnosis as well as the design of policies facilitating the prominent participation of persons in all aspects of health care.

Keywordsbridging, person-centred healthcare

43


Conference abstractInclusion and Community: the work of a cross-sectoral UK pro-gramme to deliver inclusion policy

David Morris, PhD, Professor of Mental Health, Inclusion and Community, University of Central Lancashire, United Kingdom

Correspondence to: David Morris, E-mail: [email protected]

Introduction: In the UK, action across government on social inclusion has been a key feature of mental health policy since 2004. Its effective delivery at local level depends upon integrated action with and between services, their users, mainstream agencies and communities.

Description: UK policy to address the exclusion faced by people with men-tal health problems was set out in the report of the Social Exclusion Unit in 2004 [1] and subsequently in a report of the Prime Minister’s Strategy Unit [2]. Implementation of this policy has been led by the National Social Inclu-sion Programme (NSIP) [3].

Addressing the social exclusion faced by people with mental health prob-lems in many life domains and removing barriers to their participation as active citizens in the multiple communities of which they are a part requires action which is highly integrated and co-produced, across government, within mental health services and with the communities that they serve.

The session describes the experience of NSIP in meeting this challenge with-in the complex organisational environment of England’s health and social care system. It reviews the outcomes of the programme and describes the structured mix of national, regional and local action programme that has been necessary to these outcomes.

It details the importance of innovative leadership, cultural change in the workforce and new forms of engagement with communities in bringing about inclusion outcomes. It outlines the national and international devel-opment of networked university/service partnerships as a means of achiev-ing these goals through evidence and practice.

Keywordsmental health, inclusion, community, social inclusion programme

[1] Social Exclusion Unit (2004) Mental Health and Social Exclusion: Social Exclusion Unit Re-port London: Office of the Deputy Prime Minister[2] Cabinet Office (2006) Reaching Out: An Action Plan on Social Exclusion London HMSO[3] www.socialinclusion.org.uk

BRIDGING KNOWLEDGE


Conference abstractBridging policies and practice: Challenges and opportunities for the governance of disability and ageing

Ursula Naue, PhD PhD, Senior Researcher, Life-Science-Governance Research Plat-form, Department of Political Science, University of Vienna, Vienna, Austria

Correspondence to: Ursula Naue, E-Mail: [email protected]

Introduction: Ageing and disability represent two policy fields which need to be jointly re-thought in the context of an increasingly ageing society with a growing number of persons with disabilities. So far, policymakers and other political actors have not adequately reacted to these changing demographics.

Description of policy and practice: The two policy fields are based upon different presuppositions. Also, disability and ageing interest groups set different objectives and agendas. As several political actor groups with di-verse interests and goals operate in the political space, efforts to bridge policies and practices in ageing and disability are confronted with several challenges.

Conclusion: To be able to create a policy framework for disability and age-ing, it is necessary that interest groups formulate shared political priorities. These interest groups have to convince other political actors that new poli-cies (not only focusing on ’active/healthy/normal ageing’ vs. ‘non-healthy/not normal ageing’) are necessary for being able to cope with changing demographics.

Discussion: It is necessary to re-think current disability and ageing policies and also the objectives formulated by diverse interest groups in both fields. Overlap of contents exist which mutually informs the other field and can help to influence policymaking and policy practices with regard to an age-ing population with a growing number of persons with disabilities.

Keywordsgovernance of disability and ageing, policy and practice, bridging agendas and objectives

45


Conference abstractMeasuring social care outcomes

Ann Netten, Professor of Social Welfare, the Personal Social Services Research Unit, University of Kent, Canterbury, Kent, United Kingdom

Correspondence to: Ann Netten, E-mail: [email protected]

Background: The objectives of improving effectiveness and efficiency re-quire that we understand the impact of interventions but measuring and monitoring outcomes in social care presents particular challenges.

Methods: The developing Adult Social Care Outcome Toolkit (ASCOT) incor-porates nine domains of outcome that are weighted to reflect their relative importance using population preference weights. The full measure uses in-terview or observational techniques to establish current and expected lev-els of need in each domain. The measure can be linked to routine indicators to provide an indirect approach to monitoring the value of services in which we identify the potential value that could be delivered by a service or inter-vention: Capacity for Benefit; and the degree to which that value is actually delivered through a measure of quality.

Results and conclusions: While ongoing work is developing the measure, previous versions have proved reliable and been successfully applied across client groups in a variety of contexts.

Discussion: The results suggest that the measure should provide a theoreti-cally grounded method of reflecting the full value of social care. Moreover, the Capacity for Benefit approach potentially provides a pragmatic basis for comparability – over time, between changing systems and across different countries.

Keywordssocial care, outcomes, measurement

BRIDGING KNOWLEDGE


Conference abstractUsability of assistive technologies in ageing and disabilities

Claudia Oppenauer, MSc, Doctoral Student, Faculty of Psychology, University of Vienna, Austria

Correspondence to: Claudia Oppenauer, E-mail: [email protected]

Introduction: Assistive technologies (AT) enable older and/or disabled people to age as long as possible in place by supporting them in various tasks and activities of daily living. AT range from low technologies such as walkers or book holders to high technologies, for instance alarm systems or voice-controlled computer input systems. Besides financial costs and acces-sibility, usability has the highest impact on actual technology use. Therefore it is necessary to enhance effectiveness, efficacy and user satisfaction of the technical device.

Review of the literature: Research about awareness and perceptions con-sidering AT and corresponding methodologies is relevant in order to in-vestigate possible barriers and reasons for non-use. Psychological models emphasize the role of attitudes, social norms and self-efficacy. Prerequisites of acceptance and use will be discussed.

Discussion: Although there is a high number and variety of AT in Europe, little is known about acceptance and use of AT. Evidence-based-research is needed in order to enable cost-benefits-analysis of AT. Since enhancement of autonomy and competence of persons with disabilities should also be a matter of health care and social policies, political decisions are necessary for successful implementation of AT and rehabilitation.

Keywordsassistive technology, usability, acceptance, social inclusion

47


Conference abstractBridging knowledge in ageing and disabilities: Experiences from private funding sources in Spain

Miquel Perdiguer, Director, Obra Social Caixa Catalunya, Barcelona, Spain

Correspondence to: Miquel Perdiguer E-mail: [email protected]

Introduction: The role of private funding in long-term care programmes (LTC) is increasing worldwide. As stated by the World Health Organisation (WHO), funding is a major tool for policy and planning. Although this is well accepted in the public sector, the policy aspects of private funding have been largely overlooked in the European countries, particularly in those with a consolidated welfare system. In these countries the private sector should complement the public sector in funding and promoting in-novative strategies and change.

Description: Fundació Caixa Catalunya (FCC) is one of the 10 major private funding organisations in Spain. It is part of the social care work of the savings bank “Caixa de Catalunya”. This institution is not only interested in providing funding for social care as usual, but it is also concerned with the development of innovative programmes in these areas. These programmes include a series of initiatives directly related to knowledge transfer and innovation such as the intergenerational living programmes, and the specific call for innovative support in Alzheimer disease, among several others.

Conclusion: Private funding may play a key role in the development of bridging and translational approaches to disabilities and ageing in Europe.

Keywordsageing, disabilities, private funding

BRIDGING KNOWLEDGE


Poster abstractKnowledge Discovery from Data and Monte-Carlo DEA to evaluate technical effi ciency of mental health care in small health areas

Carlos García-Alonso, PhD, Professor, ETEA Business Administration Faculty, Cor-doba, SpainLeonor Pérez-Naranjo, Economist, Lecturer, School of Management, University of Pablo de Olavide, Seville, Spain

Correspondence to: Leonor Pérez-Naranjo, E-mail: [email protected]

Introduction: Knowledge management, based on information transfer be-tween experts and analysts, is crucial for the validity and usability of Data Envelopment Analysis (DEA).

Aims: To design and develop a methodology: i) to assess technical efficiency of small health areas (SHA) in an uncertainty environment, and ii) to trans-fer information between experts and operational models, in both direc-tions, for improving expert’s knowledge.

Method: A procedure derived from Knowledge Discovery from Data (KDD) is used to select, interpret and weigh DEA inputs and outputs. Based on KDD results, an expert-driven Monte-Carlo DEA model has been designed to assess the technical efficiency of SHA in Andalusia.

Results: In terms of probability, SHA 29 is the most efficient being, on the contrary, SHA 22 very inefficient. 73% of analysed SHA have a probability of being efficient (Pe) greater than 0.9 and 18% smaller than 0.5.

Conclusions: Expert knowledge is necessary to design and validate any op-erational model. KDD techniques make the transfer of information from experts to any operational model easy and results obtained from the latter improve expert’s knowledge.

KeywordsMonte-Carlo DEA, expert-based effi ciency, bridging knowledge

49


Conference abstractExperiences from private funding sources: Austria

Franz Karl Prüller, Programme Director Social Affairs, ERSTE Foundation, Vienna, Austria

Correspondence to: Franz Karl Prüller, E-mail: [email protected]

Established in 2003, ERSTE Foundation has a history stretching back 190 years to the year 1819 when it was founded as the Erste Österreichische Spar Casse in Vienna. Rooted in our history as a social enterprise and finan-cial service provider, ERSTE Foundation recognises that contemporary soci-ety faces huge challenges and that for a new and united Europe to work, integration is crucial - and that means uniting the economic, cultural and social capital of our region.

We develop ideas and concepts to increase social participation and to en-sure that no-one is left out, whatever their circumstances - which in turn creates stable, effective and fairer societies.

European Integration is important to us. We want to work against preju-dice and nationalism, to integrate thinking and living across borders, and make these experiences accessible, particularly to the young generation.

We intend to play an active role in giving people opportunities to increase their understanding of each other.

Therefore ERSTE Foundation has supported research projects that concern themselves with the effects of societal transformation processes: in particu-lar we have been looking at the effects that demographic changes will have on the long term care needs of elderly people in Central and Eastern Eu-rope. From this we intend to develop policy recommendations for decision makers in civil society, economy and politics.

KeywordsERSTE Foundation, private funding

BRIDGING KNOWLEDGE


Keynote abstractCrossing network lines between ageing and disabilities

Michelle Putnam, Ph.D., Assistant Professor, School of Social Work, Simmons Col-lege, Boston, Massachusetts, United States

Correspondence to: Michelle Putnam, E-mail: [email protected]

Introduction: In the United States, ageing and disability public policies, pro-grams, and service systems have historically separate origins, age-based cat-egorical eligibility, and distinct funding streams. This division creates bar-riers in serving persons ageing with disability transitioning from disability to ageing service systems and for older adults obtaining independent living services in disability systems.

Description of policy practice: Professional cross-network collaborations can bridge ageing and disability service networks. Barriers to cross-network col-laborations include competition for public funds, lack of professional cross-system knowledge, unfamiliarity with non-traditional consumer groups, and limited organizational interest or administrative knowledge of how to build and maintain collaborative relationships. Demonstrated successful collaborations and coalitions have strong leadership, organizational sup-port, partners with shared interests and goals, clear missions, and strong investment by professional staff and service system clients.

Conclusions: There is growing evidence that the work of crossing network lines is locally implemented and sustained. Large scale government man-dates can help initiate this process.

Discussion: Service networks include governmental (public) and non-gov-ernmental (private) organizations. Collaboration is mainly voluntary, but encouraged by: growth in home and community based care, demand for community integration by people with disabilities, and the need for fiscal efficiency and demonstrated performance results in government spending.

Keywordsageing, disability, collaboration, long-term care, independent living

51


Conference abstractLocal, regional and national experiences on bridging: US perspectives

Michelle Putnam, Ph.D., Assistant Professor, School of Social Work, Simmons Col-lege, Boston, Massachusetts, United States

Correspondence to: Michelle Putnam, E-mail: [email protected]

Introduction: Bridge building work in the United States is primarily local and voluntary, involving professionals at individual agencies and organiza-tions (public and private) who work towards specific goals. However federal mandates intended to reduce nursing home admissions and increase access to home and community based services through new model collaboration programs are hastening this work.

Description of policy practice: Successful short-term “grassroots” coalitions advocating for specific health insurance benefits and program funding for poor older adults and people with disabilities are common in all regions, but rarely build permanent bridges across networks. Voluntary cross-network collaborations, such as the Partners III program in Virginia (1993-1996), suc-cessfully established regionally specific long-term alliances. Nationally, the federal government is pilot testing 140 Ageing and Disability Resource Cen-tres (ADRC’s) to facilitate permanent cross-network collaboration through coordination of consumer information and referrals across service systems. Financial and technical assistance is provided ADRC’s; interim results are positive.

Conclusions: Sustainment of cross-network bridges is a priority.

Discussion: Voluntary cross-network collaborations are difficult to sustain long-term and are dependent on interest, leadership, perceived profes-sional need, and funding support. Federal intervention and commitment to bridge historical service network “silos” may create institutional change that fosters greater cross-network collaboration.

Keywords ageing, disability, service network, collaboration, long-term care, independent living

BRIDGING KNOWLEDGE


Conference abstractPrivate stakeholders and providers: the experience of Edad&Vida Foundation

Higinio Raventós, President, Edad&Vida Foundation, Barcelona, Spain

Correspondence to: Higinio Raventós, E-mail: [email protected]

Introduction: Demographic change and population ageing are global pro-cesses without precedent. The twenty-first century will witness even more rapid ageing than did the century just past and governments, private sector as well as civil society should work together to give answers to the social and economic challenges we will all be facing.

Description: Edad&Vida (Age and Life) (www.edad-vida.org) is from 2001 the meeting point of private companies, elderly associations and academic institutions, who work together to give an answer to the needs of elderly people and to promote initiatives to improve their quality of life in a re-sponsible and sustainable way. Our “raison d’être” is promoting the joint responsibility and balance between the public sector and the private ini-tiative, with the aim of responding to the economic and social challenges of an ageing population. In this sense, some of the recommendations of Edad&Vida to the public administrations are: a stable and clear legal frame-work for the private initiative to make the necessary investment efforts; the health and social care integration; an offer of quality services to the elderly people and the accreditation system to guarantee this quality; a fair cor-relation between costs and prices paid; the long-term care system sustain-ability through co-payment...etc.

Conclusions: Edad&Vida Foundation is a reference and pioneer institution in Spain and in Europe and fosters the dialogue and cooperation among public and private sector as well as elderly associations and academic insti-tutions with the aim of improving the quality of life of elderly people.

Keywordsedad&vida, demographic change, population ageing, economic and social chal-lenges, quality of life, elderly

53


Conference abstractAccessibility and assistive products

Cristina Rodríguez-Porrero Miret, Director, National Reference Centre for Per-sonal Autonomy and Assistive Technologies (CEAPAT), Madrid, Spain

Correspondence to: Cristina Rodríguez-Porrero M., E-mail: [email protected]

Introduction: Accessibility and assistive products and technologies are need-ed to ensure the rights of persons with disabilities and older persons. Many developments have been implemented in laws, standards, markets and from the consumers perspective, at international, European and national levels. The real issue is that not all the potential users benefit from the use of assistive products or accessible measures.

Discussion: Innovative methods are needed to allow all potential users to have real advantage of assistive technologies and accessible and design for all facilities. Best practices will be presented and existing gaps and recom-mendations will be discussed. Cost-benefits aspects will also be presented.

Conclusion: In order to get advantages from opportunities of globalization, hard work and responsibilities of all stakeholders are needed, so that assis-tive products and accessibility reach a whole range of situations and envi-ronments and contribute to ensure quality of life in a society for all.

Keywords:accessibility, assistive products, technologies, disabilities, elderly

BRIDGING KNOWLEDGE


Poster abstractComparative study of mental health services availability and use in Chile and Spain

Cristina Romero, Asociación Científi ca PSICOST, Jerez de la Frontera, Spain José Alberto Salinas, Asociación Científi ca PSICOST, Jerez de la Frontera, Spain Sandra Saldivia, Universidad de Concepción, Concepción, Chile Pamela Grandón, Universidad de Concepción, Concepción, Chile Miriam Poole, Asociación Científi ca PSICOST, Madrid, Spain Luis Salvador-Carulla, Asociación Científi ca PSICOST, Jerez de la Frontera, SpainJuan C. García Gutierrez, Universidad de Cádiz, Spain

Correspondence to: Cristina Romero, E-mail: [email protected]

Introduction: There is an enormous interest about improving internation-al comparisons to provide relevant information for policy and planning in mental health. Most of the available information is provided at the macro-level (countries or regions). However, information gathered at the meso-level may diverge from data aggregated at higher territorial levels.

Objectives: This study describes the comparison on availability and use of mental health services between Chile and Spain.

Methods: Availability and utilization of services for the adult population were assessed in two urban areas in Chile and in three (two urban and one rural) areas in the South of Spain by using the European Service Mapping Schedule (meso-level data).

Results: For the two countries, local data on availability differed from data provided at the national level. There were differences in use of residen-tial and day care between the benchmark area in Spain and the areas ex-plored in Chile. In Chile’s catchment areas there was no availability of non acute hospital services, any work-related services for persons with mental disorders, or 24-hour mobile or non mobile emergency psychiatric care. The meso-level data indicated that delivery and use of care in Chile was more similar to the pattern found in the poorer area in Southern Spain than mac-ro-level data would indicate.

Conclusions: The European Service Mapping Schedule was useful for de-scribing mental health care outside of Europe and allowed for an inter-national comparison between Chile and Spain. The meso-level description gathered in this study adds to the macro-level information on the mental health care system that has been provided in other reports.

Keywordsmental health care, services utilisation, availability

55


Poster abstractImplementation of the Dependency Law in Spain. The activities- based cost systems as tools that can facilitate decision-making for the implementation of the Law

Mercedes Ruiz Lozano, Professor, Business Management and Quantitative Methods Department, Economics and Management Science Faculty, INSA-ETEA, University of Cordoba, Cordoba, SpainAraceli de los Ríos Berjillos, Professor, Business Management and Quantitative Methods Department, Economics and Management Science Faculty, INSA-ETEA, University of Cordoba, Cordoba, SpainPilar Tirado Valencia, Professor, Business Management and Quantitative Methods Department, Economics and Management Science Faculty, INSA-ETEA, University of Cordoba, Cordoba, Spain

Correspondence to: Mercedes Ruiz L., E-mail: [email protected]

The coming into force in 2007 of Law 39/2006 about Promotion of Personal Autonomy and Care for people in a situation of dependency has created the right of everyone in these circumstances to be served by public services. This law involves an expansion and complement of the protective action of the State and Social Security System.

To date these people have been treated by state, regional and local services by Plans of Action for People with Disabilities or Plans for Older People, and also by the Social Security System through some benefits of it. Social Ser-vices Area of the city councils has also been rendering a service in the basic benefits in terms of available resources.

The Spanish Federation of Municipalities and Provinces (FEMP) has supported the execution of a project to implement a cost system in the municipalities. Some municipalities have joined this project in partnership with several univer-sities. We have studied different areas of the municipalities, including Social Services, where we have identified: assistance, required activities, consumed resources and a set of activity, cost, environment and budget indicators.

The analysis by the people in charge of Dependency Law of the information in the Social Service Area that this project can provide could help them to make efficient and effective decisions on the allocation of limited resources.

Keywordsactivities based costs systems, Dependency Law, Spain

BRIDGING KNOWLEDGE


Conference abstractCoding services for ageing and disability: eDESDE-LTC

Luis Salvador-Carulla, Asociación Científi ca PSICOST, Jerez de la Frontera, SpainMiriam Poole, Asociación Científi ca PSICOST, Madrid, SpainMurielle Bendeck, INGENIS Consulting Group, Barcelona, Spain Cristina Romero, Asociación Científi ca PSICOST, Jerez de la Frontera, SpainJosé Alberto Salinas, Asociación Científi ca PSICOST, Jerez de la Frontera, SpainThe eDESDE-LTC Group

Correspondence to: Luis Salvador-Carulla, E-mail: [email protected]

Introduction: Semantic variability is a barrier to effective networking of long-term care (LTC) services. The same name may be used for services providing different activities (i.e. day centres), and services with different names may have a similar pattern of care delivery. Furthermore, services are complex constructs which depend on local characteristics, vary over time and do not allow comparisons like with like. At present there is no standard coding sys-tem of LTC in Europe. This fact impedes cross-national comparisons, hampers European statistics on service availability, access and use, and slows down the development of international care planning strategies and patient mobility.

Description: The “Description and Evaluation of Services and Directories in Europe” (DESDE) adapts to LTC the only currently available methodology for mapping, comparing and monitoring mental health and disability services (European Service Mapping Schedule – ESMS), which has already been applied in 16 countries in Europe. The system is based on descriptors called “Main Types of Care” (MTC) including accessibility, information, self-help, outpatient and community care, day care and residential care. Services are arranged or organised in cluster combination of MTCs which emulate “bar codes”, identi-fying service characteristics according to MTCs. Thus, MTC availability and use can be compared across areas regardless of how services are named.

Conclusion: DESDE is a standard coding system of services for LTC which can be incorporated to electronic registers, databases and websites.

Keywordslong term care, coding system, services

57


Conference abstractThe concept of “functional dependency”

Luis Salvador-Carulla, MD, PhD, Asociación Científi ca PSICOST, Jerez de la Fron-tera, Cádiz, Spain

Correspondence to: Luis Salvador-Carulla, E-mail: [email protected]

Introduction: In Europe the concepts of “Functioning/Disability” and “Au-tonomy/Dependency” deserve special interest from the point of view of medical ontology. While Functioning/Disability are concepts defined at the WHO International Classification of Functioning (ICF), the Autonomy/De-pendency pair is not even mentioned at this classification system.

Description: The Council of Europe has defined “dependency” as the condi-tion related to the loss of autonomy and the need of support by a third per-son related to an impairment of activities of daily living, specially self-care. Laws and care services for the elderly and for persons with severe disability have been developed following this paradigm in several EU countries. These concepts are based in the Activities of Daily Living construct (ADLs) which divides these activities in basic and instrumental. This construct cannot be linked to the WHO-ICF paradigm as stated in the Spanish law. WHO has defined “Personal Autonomy” as equivalent to self-direction, competence and self-empowerment, and there is no equivalent definition of function-related autonomy at the WHO Family of Classifications.

Conclusion: The different background of these concept pairs had a signifi-cant impact on the development of health and social services in several European countries during the last decade. This is particularly important for those conditions where impairment is not related directly to basic ADLs but to other functional problems such as severe mental illness or intellectual disability. The ontological disparities need careful review to avoid inequity in access to care for severe disability in Europe.

Keywordsfunctional dependency, disability, autonomy, functioning

BRIDGING KNOWLEDGE


Poster abstractThe well-being of Iranian mothers and fathers who have children with developmental disabilities

Sayyed Ali Samadi, PhD student, Institute of Nursing Research, University of Ulster, Northern Ireland, United Kingdom Roy McConkey, Professor in Learning Disability, Institute of Nursing Research, Uni-versity of Ulster, Northern Ireland, United Kingdom

Correspondence to: Sayyed Ali Samadi, E-mail [email protected]

Introduction: The negative impact on mother’s wellbeing of having a child with developmental disabilities is well established in Western societies. By contrast less research has been undertaken in other cultures or with fa-thers.

Method: A convenience sample of 91 parents was recruited in Tehran: 50 parents of children with intellectual disabilities and 41 parents of children with autism spectrum disorder. A Farsi translation of two widely used scales - General Health Questionnaire (GHQ) and Parental Stress Index - was used to gauge parental wellbeing.

Results: Mothers had significantly higher scores than fathers on the GHQ and had higher levels of child-related stress. Also both mothers and fathers of younger children tended to have significantly higher stress scores as did those whose children had ASD.

Conclusion: Hence in Middle Eastern countries such as Iran, mothers in par-ticular face stress and health problems as a consequence of caring for a child with developmental disabilities and these seem to be more marked when the child has ASD.

Discussion: Further research is needed with fathers around their decreased involvement with the affected child and cultural expectations that fathers should be able to cope. These findings may also have implications for carers of older persons in non-Western societies.

Keywords autism spectrum disorder, intellectual disabilities, parental stress, parental general health, Iran

59


Conference abstractInstitutional sources of trust in government contracting: a compar-ison between home-based and residential social services in Spain

Angel Saz-Carranza, PhD, Post-Doctoral Research Fellow, Institute of Public Man-agement, ESADE Business School, Barcelona, SpainAlbert Serra, Associate Professor, Institute of Public Management, ESADE Business School, Barcelona, Spain

Correspondence to: Angel Saz-Carranza, E-mail: [email protected]

This interview-based study explores trust in public-private cooperation by addressing the research questions: What are the main sources of distrust in public-private contracting? And why? We compare two Spanish social ser-vices subfields: one with high levels of cross-sector distrust and another one with no distrust between public and private sectors.

The sources of the identified cross-sector distrust are institutional: insuffi-cient regulation and legislation, lack of business certification, and low local government administrative capacity. The article is a pioneering exploration of the under-researched theme of institutional distrust and its effect on public-private cooperation management.

This research is a product of the Research Group on Innovation and Leader-ship in Public Management and has counted with the support of the Span-ish Ministry of Education and Culture (MEC SEJ2006-00961).

Keywordstrust, social services, management, institutions, public-private

BRIDGING KNOWLEDGE


Conference abstractIntegrated care and disease management as a bridge in ageing and disabilities

Guus Schrijvers, Editor in Chief, International Journal of Integrated Care and Pro-fessor, Public Health, UMC Utrecht, Holland

Correspondence to: Guus Schrijvers, E-mail: [email protected]

Integrated care is provided by professionals with different disciplines, com-petencies and degree of specialization with the first objective to promote cooperation and with a final objective to promote quality and efficiency of care. Following the degree of integration four models can be distinguished: No integration, linkage, coordination and full integration.

An optimal degree exists for integrated care in relation to cost and qual-ity. This optimum depends on local circumstances. Another distinction is horizontal integration (within PHC or hospitals) and vertical integration (between PHC and hospitals). An example of horizontal integration is the One Stop Shop. Disease Management Programmes are examples of verti-cal integration. In integration the use of Health Information Technology is important, for instance for integrated education programs for patients, telemonitoring, telemedicine, work flow management and feedback to pa-tients and professionals. The PMPM (Per Month Per Member) are important indicators for the efficiency of integrated care.

Keywordsintegrated care, disease management, disabilities, ageing

61


Conference abstractIncorporating bridging to scientifi c literature

Guus Schrijvers, Editor in Chief, International Journal of Integrated Care and Pro-fessor, Public Health, UMC Utrecht, Holland

Correspondence to: Guus Schrijvers, E-mail: [email protected]

Research results on integrated care are usually disseminated after a study, in journals with a high impact factor and with an emphasis on outcome in-dicators. In this dissemination several bottlenecks appear:• the evaluated intervention is described in a too short way, • a description of care as usual is seldom given,• results are available after two or three years after finishing the interven-tion period,• the influence of the context of the experiment is seldom controlled, and• alternative hypotheses are seldom tested.

That’s why the International Journal of Integrated Care (IJIC) and other journals try to find new ways of dissemination with more emphasis in the content of integrated care and not only in scientific papers. The dissemina-tion takes place also in congresses, or websites and during courses, study trips and workshops.

In the Netherlands this way of bridging “the academy” to “the field” and to “policy makers” is rather popular. Decisions on research programs and topics are made not only by researchers but also by health professionals, policy makers and finally parliament. In the lecture I will work out this Dutch model.

Keywordsscientifi c literature, bridging, integrated care

BRIDGING KNOWLEDGE


Poster abstractChronic Conditions Management Model (CCMM) for primary care in the U.K.

Malcolm Clarke, PhD, Senior Lecturer, Department of Information Systems and Computing, Brunel University, Uxbridge, United KingdomUrvashi Sharma, MSc, Research Student (PhD), Department of Information Systems and Computing, Brunel University, Uxbridge, United Kingdom

Correspondence to: Urvashi Sharma, E-mail: [email protected]

Introduction: Chronic condition management has been structured around models that aim at facilitating and development of care through initiatives of self-management, organisational restructuring and information system enhancement.

Aim: Investigate issues around UK’s health care framework adopted for chronic condition management.

Results: UK’s health care framework for chronic condition care draws upon the Chronic Care Model and Innovation Care for Chronic Conditions frame-work. However, consideration to the clarity or vagueness of boundaries between different hierarchical structures and awareness of each structure about its focus and contribution to overall health system are not taken into account by these models. The proposed Chronic Condition Management Model is different as it’s targeted at primary care which plays a salient role of gate keeping. Change implemented here would lead to better clinical effectiveness, increase in efficiency of the system and reduction in cost. This model does not directly call for policy change; instead it recommends incorporating available evidence into the policy. It calls for empowering the patient by providing health literacy and improving awareness, and for collaboration and cooperation between primary, secondary, tertiary, com-munity and social care services.

Conclusion: Initiatives towards chronic condition management should be enacted at primary care due to its gate keeping role in the UK’s health care system.

Keywordchronic condition management, primary care, chronic condition management model, United Kingdom

63


Conference abstractTransfer knowledge for younger generations

Josep Solans, Director, Social Care Area, Fundació Caixa Catalunya, Barcelona, Spain

Correspondence to: Josep Solans, E-mail: [email protected]

Introduction: Nowadays there is an important distance between genera-tions in our society, especially between senior citizens and young people, who do not regularly live together. In addition, it has been demonstrated that the transfer of knowledge and experience, are the keys to sustain-ability of culture and tradition, as well as the transfer of values. In this con-text, it is necessary to promote actions and programmes that bring together these two generations, establish both time and space to share.

Description: The Intergenerational Viure i Conviure Programme of Caixa Catalunya, of homeshare between senior citizens and young university stu-dents, as well as other similar European programmes, provide participants the necessary time and space for knowledge transfer. The experience gath-ered in this programme has shown us the importance of the relation be-tween generations and the numerous values and benefits obtained by its participants. Values such as solidarity, tolerance, respect for other cultures and political views, among others, are clear examples. For over 12 years, more than 2000 homeshare couples in the Viure i Conviure programme have been formed and the programme’s positive effect on senior citizens and young university students has been proven.

Conclusion: This experience of living together among generations, and other similar ones in Europe, as well as other experiences between differ-ent groups (for example, with persons with Down Syndrome) demonstrate the relevance of the intergenerational programmes in long term care in Europe.

Keywordsyounger generations, knowledge transfer, homeshare, intergenerational pro-grammes

BRIDGING KNOWLEDGE


Conference abstractInformation and communication technology in learning develop-ment and rehabilitation

José Mª Tormos, MD, PhD, Research Director, Institut Universitari de Neurorehabili-tació Guttmann, Badalona, SpainAlberto García-Molina, PhD Student; Institut Universitari de Neurorehabilitació Guttmann, Badalona, SpainAlejandro García-Rudolph, Med Eng, Institut Universitari de Neurorehabilitació Guttmann, Badalona, Spain Teresa Roig, PhD, Institut Universitari de Neurorehabilitació Guttmann, Badalona, Spain

Correspondence to: Jose Mª Tormos, E-mail: [email protected]

Introduction: There is still no evidence to base interventions on neuropsycho-logical rehabilitation or cognitive stimulation related with learning develop-ment. There are two main problems to solve. The first is the sustainability of the clinical interventions. The second one is the lack of evidence. This is not derived at all from a lack of studies but to methodological difficulties finding trials suitable for meta-analysis. This is a real hazard for translational research because of the difficulties of developers in testing new designs and showing efficacy, and also for the development of the body of knowledge, making difficult to find main theories and design appropriate experiments.

Description of care: ICTs have profoundly modified this scenario. Advanc-es in communication technologies allow delivery of intensive, personal-ized, monitored neuropsychological intervention, through telerehabilita-tion platforms, and cognitive neuroscience based content, to guide plastic changes towards the recovery of more appropriate behaviour. Advances in information technologies have provide new possibilities to assess efficacy, opening new pathways to knowledge discovery from databases generated from clinical practice.

Conclusion: Institute Guttmann, from its initiative PREVIRNEC, is pioneer-ing the application of this dual approach, bridging knowledge to the end user through communication technologies (internet) and extracting implicit knowledge (efficacy on neuropsychological rehabilitation) from data gen-erated from each intervention.

Keywordsneuropsychological rehabilitation, cognitive stimulation, effi cacy, effi ciency, telere-habilitation

65


Keynote abstractBeyond classifi cations: entities of knowledge exchange

Bedirhan Üstün, Coordinator, Classifi cation, Terminology and Standards Unit, World Health Organization (WHO), Geneva, Switzerland

Correspondence to: Bedirhan Üstün, E-mail: [email protected]

Introduction: WHO’s reference classifications, ICD and ICF have traditionally served as standards for disease, health and disability related data. To meet the requirements of health (and disability) information systems in the 21st century WHO classifications need to represent the knowledge digitally in a coherent semantic structure. The knowledge representation in a classification requires that the information entities need to be identified with clear attri-butes and values and put into the context of an overall information model.

Aims: To identify how we can possibly build mechanisms for meaningful data exchange in health information systems and discuss the prospects and implications for digital systems for public health.

Results: Digitalization of health and disability information system is an emerging need around the world. The transition from an analogue (and usually unsystematic information compilations) to digital health informa-tion system is a common observed trend which is expected to gain domi-nance in forthcoming decades. The Information Communication Technology (ICT) developments have created multiple workstreams to this field which are usually summarized as e-health. Further to the digital technology, the need to define and provide the content standards is a shared responsibility of the both content and technology stakeholders: One needs to define the content in a analogue form first, then convert into a digital application. Each health information rubric should be operationally defined and then be digitally represented in computerized information systems. To achieve this aim ontology as a computer science provides the scientific discipline and practical tools to define entities with their attributes and values. Creat-ing the ontological basis for classifications will enable to represent the un-derpinning knowledge structure in an operational way; describe the logical rules as to how they relate to each other, identify measurable properties and provide a basis to share information both digitally and among humans irrespective of linguistic differences. In this way, health and disability infor-mation can be harmonized and aggregated at both individual and popula-tion levels.

Conclusions: Formalized knowledge representation will allow for better construction of health and disability information, enable research and pol-icy making by allowing meaningful exchange aggregation of data from multiple sources and enable science based decision making.

KeywordsWHO Classifi cations, ICF, knowledge representation, ontology

BRIDGING KNOWLEDGE


Conference abstractQualitative and quantitative research methods

M Luisa Vázquez, MD, PhD, MSc, Research Head, Health Policy Research Unit, Con-sorci Hospitalari de Catalunya, Barcelona, Spain

Correspondence to: M Luisa Vázquez, e-mail: [email protected]

Introduction: Research in the area of health has been traditionally dominat-ed by quantitative research. However, the complexity of ill-health, which is socially constructed by individuals, health personnel and health authorities have motivated the search for other forms to approach knowledge.

Aim: To discuss the complementarities of qualitative and quantitative re-search methods in the generation of knowledge.

Contents: The purpose of quantitative research is to measure the magni-tude of an event, to make predictions, develop causal explanations. To achieve this it uses a pre-established design based on hypothesis and theo-ries, conducts extensive data collection to a statistical sample and develops statistical data analysis. Quantitative research to establish the incidence or prevalence of a health problem; health personnel degree of adherence to a new intervention; or, users’ level of satisfaction with a service. Qualita-tive research aims at understanding what exists from social actors’ perspec-tives. Its design is open, flexible and circular, data collection is intensive and based on a purposive sample and results will be achieved through inductive analysis. Qualitative research allows to explore aspects thought as known, understand differences in personnel opinions and practice in front of new interventions or users’ opinion on services utilization.

Conclusion: Quantitative and qualitative methods are different research approaches, that not only provide complementary knowledge that contrib-utes to gaining better understanding of a problem or situation, but that can be used in a combined way, to approach a new research area, to de-velop instruments and to interpret results.

Keywordsqualitative methods, quantitative methods, research

67


Conference abstractExperiences from research agencies

Britt Venner, Research Director, SINTEF Health Services Research, Trondheim, Nor-way

Correspondence to: Britt Venner, E-mail: [email protected]

Introduction: SINTEF Health Services Research is part of the SINTEF Founda-tion. Research areas are evaluation of health and welfare services. The health and welfare authorities are the main commissioners of our research.

Policy practice: SINTEF is the main supplier of research on health and social service reports to the authorities. The institute has competence on hospi-tal and outpatient services to somatic and psychiatric patients (acute treat-ment, rehabilitation and joint efforts from different agencies). The same principles apply to delivery of services, irrespective of whether it is disability or old age: Hospitals provide specialist competence in diagnostics and treat-ment. Rehabilitation is provided both by specialists and community services. Long-term care is provided in the person’s home as long as possible, both for people with disabilities and people of old age.

Conclusion: Independent research and evaluation are used by policy makers to continually evaluate and improve services.

Discussion: Health and welfare policies in Norway are generally the same for both elderly persons and persons with disabilities, provided by hospitals and community services.

Keywordsmonitoring services, research, integrated health and social services

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Conference abstractHealth indicators for persons with intellectual disabilities in Europe

Patricia Noonan Walsh, NDA Professor of Disability Studies (School of Psychology), UCD, Belfi eld, Dublin, Ireland Germain Weber, Univ.-Prof. Dr, Institut für Klinische, Biologische und Differentielle Psychologie, Universität Wien, AustriaMargarida Nadal, on behalf of the Pomona Group, Barcelona, Spain

Correspondence to: Patricia N. Walsh, E-mail: [email protected]

Introduction: People with intellectual disabilities comprise an estimated 5 million persons in the EU 27 member states. Evidence suggests that people in this group show negative disparities in health status and in access to optimal health care. They are more likely to incur secondary health condi-tions and thus report increased morbidity and poorer health status. Higher rates of obesity, mental health disorders, and lower rates of cardiovascu-lar fitness, vaccination levels, and preventative health screening have been identified among people with intellectual disabilities. Epilepsy and mental health difficulties have a high rate of prevalence. To identify health dispari-ties, measures to gather comparable health data are required. This presen-tation outlines the procedures adopted to develop and implement a set of health indicators for persons with intellectual disabilities in Europe.

Methods: With support from the DG-Public Health of the EU, the Pomona group developed a set of 18 health indicators for persons with intellectual disabilities (2002-2004). Partners operationalized these indicators in a sur-vey instrument, translated this into 14 languages, secured ethical approval, carried out a pilot study and gathered data among N=1269 participants.

Results: Most (77%) lived independently or semi-independently, with their families or in group homes with fewer than 16 residents. Countries varied in the proportion of persons living in hospitals or nursing homes. About one-half of participants were in the ‘overweight’ or ‘obese’ categories. Rates of health checks were not optimal, especially for gender-specific conditions.

Discussion: Results are discussed in the light of priorities for gathering and maintaining health information systems that can help to identify health needs of persons in this segment of the population, and efforts at European level to decrease health inequalities.

Keywordshealth indicators, health information systems, intellectual disabilities

69


Conference abstractBridging the fi elds of disability and ageing: the Graz Declaration on Disability and Ageing

Germain Weber, Dr.phil. Professor of Psychology, University of Vienna, Faculty of Psychology, Austria

Correspondence to: Germain Weber, E-mail: [email protected]

Introduction: Traditionally the fields of ageing and disability have been addressed separately both in terms of research and service structures and systems of care. However, in recent years, public awareness into topics in-volving ageing and disability – twin-track approach - has been growing and research linking both fields enjoys rising attention.

A twin-track model: Ageing as viewed from the perspective of people with disabilities – those with life-long disabilities as well as those with age-related disabilities – is the main focus of the Graz Declaration of June 2006. Considering international declarations developed separately for the fields of ageing and disability, the Graz Declaration aims at analysing and bridging the rights and responsibilities of these two groups while including the conception of the person with a disability, as expressed in principles such as inclusion, participation, equal opportunities, non-discrimination, and self-determination. The declaration aims at clarifying common variance, and emphasizes the unique requirements and needs of specific groups of older people with disabilities. Besides conceptual and strategic reasons the declaration follows straight forward reasons affecting the life of older people with disabilities directly or indirectly such as bridging the practice models of care of the ageing field with that of the area of intellectual disability, or defining tools to detect commonalities as well as differences between the needs of older people with a life-long disability and those with age-related disabilities.

Conclusion: The Graz Declaration’s effect on developing a more coherent support systems aiming at equal opportunities and full citizenship for older people with disabilities in diverse, yet integrated fields such as politics, care, training, research, culture, ethics and economics will be addressed.

Keywordsdisability, ageing, Graz Declaration on Disability and Ageing

BRIDGING KNOWLEDGE


Keynote abstractPopulation development and the need for housing for elderly people in Sweden

Barbro Westerholm, Prof. Emerita, Member of Swedish Parliament, Chairperson Elderly Housing Delegation, Stockholm, Sweden

Correspondence to: Barbro Westerholm, E-mail: [email protected]

Introduction: The need for housing adapted to the needs of elderly people will increase during the forthcoming years due to the increase of the pro-portion of elderly people from 2020 and onwards. This need cannot be resolved by means of a single limited initiative.

Description of situation: Most elderly people live in houses, farms and apartments which have to be adapted to disabilities. There is an increasing interest in Senior housing which is intended for people over a certain age. For very old and frail people who feel anxious and insecure in their present accommodation ask for a new type of housing – sheltered housing. Here the residents should have access to communal premises with the option of meals, staff and activities. There is a lack of residential care homes. This is a form of housing for elderly people who live there permanently and suffer from dementia or multiple illnesses. They are in need of social and health care round the clock.

Conclusion: The interplay between the design of the physical environment and social and medical thinking in health and social care for the elderly needs to be improved and more interdisciplinary research on housing for the elderly has to be initiated.

Key wordshousing, elderly

71


Conference abstractThe role of providers: disability

Franz Wolfmayr, President, European Association of Service Providers for Persons with Disabilities EASPD; General Manager, Chance B, Service provider in AustriaLuk Zelderloo, Secretary General, EASPD, Brussels, Belgium

Correspondence to: Franz Wolfmayr and Luk Zelderloo, E-mail: [email protected] and [email protected]

Introduction: Societies today are very complex. Effective and successful implementation of care policies is needed. The concept of stakeholder ap-proach is about creating tools and instruments to organise the communica-tion between all parties involved.

Aims: EASPD organised in 2006 the conference “ageing and disability – dis-abled people are ageing, ageing people are getting disabled” in Austria. For the first time organisations from the care sector for ageing people and from the disability sector were working together to discuss their concepts and their experience and to develop strategies. In this conference main re-sults of this cooperation will be analysed.

Results: The care sector for elderly people in many countries is now fac-ing the same problems than the disability sector 20 years ago: services are mainly medical oriented, the main solutions are care homes, services are social not right driven, the choice for individuals is very limited, … . We will come up with some suggestions to bridge the gap between the disability sector and the care sector in order to equalise the opportunities for elderly people with care needs.

Keywordsequalisation of opportunities, stakeholder cooperation, choice, human rights

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Conference abstractAutonomy and Interdependency

Luk Zelderloo, Secretary General, EASPD, Brussels, Belgium

Correspondence to: Luk Zelderloo, E-mail: [email protected]

The most remarkable development the disability sector went through over the last 10-15 years is the shift in paradigm. The shift from a medical model, a defect model, towards a social model of disability is made. The approach, today, is based on Human Rights. Full inclusion in society is the overarching objective.

For ageing people and their services a similar but less visible shift in thinking took place. Ageing people indeed should be empowered to stay active and included citizens, be it senior citizens with very specific needs and concerns. Concepts such as “empowerment”, “choice”, “individualization”, “tailor-made support”, “support for the changing needs” are equally important for both people with a disability and ageing people / senior citizens. An-other somewhat older concept is “belonging”. All human beings seem to have a clear need with regard to being part of something, being part of a group, a social structure, a family. Challenging is how to combine and bal-ance these two sets of concepts; on the one hand “autonomy”, ”choice”, “self-determination” and on the other hand: the need for “belonging”, being member of a social entity. Our today’s society and culture (over)pro-motes individualization, individual freedom and independency. The reality is interdependency. The presentation will introduce ‘inclusive interdepen-dency’ as a bridging concept.

Keywordsautonomy, inclusion, interdependency

73

NOTES

BRIDGING KNOWLEDGE

AUSTRIA

Ursula NaueSenior ResearcherLife-Science-Governance Research PlatformDepartment of Political ScienceUniversity of Vienna

Claudia OppenauerDoctoral StudentInstitute of Clinical, Biological and Differential PsychologyFaculty of PsychologyUniversity of Vienna

Franz Karl PrüllerProgramme Director, Social AffairsDIE ERSTE FoundationVienna

Germain WeberProfessor of Clinical and Health PsychologyDepartment of Clinical, Biological and Differential PsychologyDean, Faculty of PsychologyUniversity of Vienna

Franz WolfmayrPresident, EASPDGeneral Manager, Chance B, Service provider in AustriaGleisdorf

BELGIUM

Concetta CultreraHead of Sector, Unit “Social Protection, Social Services”DG for Employment, Social Affairs and Equal OpportunitiesEuropean CommissionBrussels

Elisabeth MestheneosPresident, AGE PlatformBrussels

Anne-Sophie ParentDirector, AGE PlatformBrussels

Johan Ten Geuzendam Head, Unit for EU Integration of People with DisabilitiesDG for Employment, Social Affairs and Equal OpportunitiesEuropean CommissionBrussels

Luk ZelderlooSecretary General European Association of Service Providers for Persons with Disabilities (EASPD)Brussels

BULGARIA

Hristo DimitrovDirector, Public Health AssociationSofi a

CHILE

Pamela GrandónUniversidad de Concepción

Sandra SaldiviaUniversidad de Concepción

FRANCE

Angela GarabagiuIntegration of People with Disabilities DivisionCouncil of EuropeStrasbourg

GERMANY

Alarcos CiezaSenior Researcher. ICF Research Branch of WHO FIC CC (DIMDI)Institute of Health and Rehabilitation SciencesLudwig Maximilian UniversityMunich

IRELAND

Patricia Noonan WalshNDA Professor of Disability Studies School of Psychology University College Dublin - Belfi eld

LIST OF PARTICIPANTS

75

ITALY

Matilde LeonardiHead, Neurology, Disability and Public Health UnitFondazione Istituto Neurologico Carlo BestaMilan

Massimo MoscarelliHead, International Center of Mental Health Policy and EconomicsMilan

Giuseppe TibaldiSecretary, Italian Society for Psychiatric Epidemiology (SIEP) Scientifi c Coordinator, Centro Studi e Ricerche in Psichiatria ASLTO2 Turin

LUXEMBOURG

Dieter FerringProfessor of PsychologyDirector, Research Unit INSIDEUniversity of Luxembourg

Angela RincónExecutive Agency for Health and ConsumersEuropean CommissionLuxembourg

Stefan ShreckHead, Health Programme UnitExecutive Agency for Health and ConsumersEuropean CommissionLuxembourg

NETHERLANDS

Guus SchrijversEditor in Chief, International Journal of Integrated Care Professor of Public HealthUniversity Medical Centre Utrecht (UMC) Julius Centre for Health Sciences and Primary Care

NORWAY

Britt VennerResearch DirectorSINTEF Health Services ResearchTrondheim

ROMANIA

Eva GyorkiCEO, Fundata Alpha TranssylvanaTirgu Mure

SLOVENIA

Mojca Z. DernovšekHead, Research and Development DepartmentEducational and Research Institute OZARA Ljubljana

Lilijana SprahSenior Research Fellow and Assistant Professor Sociomedical Institute, Scientifi c Research Centre of the Slovenian Academy of Sciences and Arts (SMI SRC SASA)Ljubljana

SPAIN

Federico Alonso-TrujilloSecretaryAsociación Española para el Estudio Científi co del Envejecimiento SaludableAntequera

Sara AuderaServicio Aragonés de SaludZaragoza

José Luis Ayuso-MateosProfessor and ChairmanDepartment of PsychiatryUniversidad Autónoma de Madrid

Jordi BalotHead, Social Care DepartmentFundació Caixa CatalunyaBarcelona

BRIDGING KNOWLEDGE

Murielle BendeckManaging DirectorINGENIS Consulting GroupBarcelona

Catalina BolancéAssociate Professor, RFA-IREAUniversity of Barcelona

Bonaventura BolibarIDIAP Jordi GolBarcelona

Antoni BulbenaDirectorInstitute for Psychiatric Assistance, Mental Health and Drug AddictionsInstitut Municipal d’Assistència SanitàriaBarcelona

Marta CabanasIDIAP Jordi GolBarcelona

Juan M. CabasésProfessor of EconomicsPublic University of Navarra (UPN)Pamplona

María Luisa de la PuenteGeneral Director, Planning and Evaluation Subdirector, Servei Català de la SalutDepartament de Salut Generalitat de CatalunyaBarcelona

Araceli de los Ríos B.Professor, Business Management and Quantitative Methods DepartmentEconomics and Management Science FacultyINSA-ETEA, University of Cordoba

Mònica DuaigüesHead, Social Care DepartmentFundació Caixa CatalunyaBarcelona

Carlos García-AlonsoProfessor, Operations Research and Information SystemsETEA, Business Administration Faculty University of Córdoba

Juan C. García GutierrezAssociate ProfessorUniversidad de Cádiz

Alberto García-Molina Institut Universitari de Neurorehabilitació GuttmannBadalona

Alejandro García-Rudolph Institut Universitari de Neurorehabilitació GuttmannBadalona

Karina Gibert Professor, Department of Statistics and Operations Research Knowledge Engineering and Machine Learning GroupUniversitat Politècnica de CatalunyaBarcelona

Manuel Gómez-Beneyto Coordinator, Spanish NHS Mental Health StrategyProfessor of PsychiatryUniversity of Valencia

Montserrat GuillénProfessor, RFA-IREAUniversity of Barcelona

Enric MayolasDirector, International Relations and Cooperation Departament de SalutGeneralitat de CatalunyaBarcelona

Xavier MendozaProfessor, Strategy and Business Policy DepartmentESADE Business SchoolRamon Llull UniversityBarcelona


77

Cristina MolinaDirector, Master Plan on Mental Health and Addictions Departament de SalutGeneralitat de CatalunyaBarcelona

José Miguel MoralesEscuela Andaluza de Salud PúblicaGranada

Margarida NadalAsociación Científi ca PSICOSTBarcelona

M Àngels OndivielaInstitut Català de la SalutBarcelona

Manuel PalomarProfessor, Department of Software and Computing Systems Director, Research Group of Language Processing and Information Systems (GPLSI)Universidad de Alicante

Miquel PerdiguerDirector, Obra Social Caixa CatalunyaBarcelona

Leonor Pérez-NaranjoLecturer, School of ManagementUniversity of Pablo de Olavide (Seville)

Miriam PooleDirector, Fundación FUNPRODAMIMadrid

Josep RamosMedical DirectorSant Joan de Déu, Mental Health ServicesBarcelona

Higinio RaventósPresident, Edad&Vida FoundationBarcelona

Ana RicoSenior Researcher in Public HealthNational Public Health SchoolInstituto de Salud Carlos IIIMinisterio de Ciencia e InnovaciónMadrid

Cristina Rodríguez-Porrero M.Director, National Reference Centre for Personal Autonomy and Assistive Technologies (CEAPAT)IMSERSO, Ministry of Education and Social PoliciesMadrid

Teresa RoigInstitut Universitari de Neurorehabilitació GuttmannBadalona

Cristina RomeroAsociación Científi ca PSICOSTJerez de la Frontera

Mercedes Ruiz L. Professor, Business Management and Quantitative Methods DepartmentEconomics and Management Science FacultyINSA-ETEA, University of Cordoba

José Alberto SalinasAsociación Científi ca PSICOSTJerez de la Frontera

Antoni SalvàInstitut de l’EnvellimentUniversitat Autònoma de BarcelonaBarcelona

Luis Salvador-CarullaPresident, Asociación Científi ca PSICOSTJerez de la Frontera

Angel Saz-CarranzaCoordinator PARTNERS Program in Public - Private Cooperation Institute of Public Management (ESADE)Barcelona

BRIDGING KNOWLEDGE

Albert SerraAssociate ProfessorInstitute of Public ManagementESADE Business School Barcelona

Josep SolansDirector, Social Care AreaFundació Caixa CatalunyaBarcelona

Joana Maria TaltavullGerencia de Atención Primaria de Palma de Mallorca

Pilar Tirado V.ProfessorBusiness Management and Quantitative Methods DepartmentEconomics and Management Science FacultyINSA-ETEA, University of Cordoba

José Mª TormosResearch DirectorInstitut Universitari de Neurorehabilitació GuttmannBadalona

M Luisa VázquezResearch and Development HeadHealth Policy Research UnitConsorci Hospitalari de CatalunyaBarcelona

SWEDEN

Barbro WesterholmMember of Swedish ParliamentChairperson, Health Expert Group, AGEStockholm

SWITZERLAND

Nenad KonstajsekTechnical Offi cerClassifi cation, Terminology and Standards UnitWorld Health OrganisationGeneva

Bedirhan ÜstünCoordinatorClassifi cation, Terminology and Standards UnitWorld Health OrganisationGeneva

UNITED ARAB EMIRATES

AbdelAziz AbdelmotiChair, Special Education DepartmentCollege of EducationUnited Arab Emirates UniversityAl-Ain

UNITED KINGDOM

Sara ArberDepartment of SociologyUniversity of SurreyGuilford

Julie Beadle-BrownSenior Lecturer in Learning DisabilitiesTizard Centre. University of KentCanterbury

Jennifer BeechamPSSRU, London School of EconomicsLondon

James ChurchillChief Executive Offi cerAssociation for Real Change (ARC)Chesterfi eld

Malcolm ClarkeSenior LecturerDepartment of Information Systems and ComputingBrunel UniversityUxbridge

Emma CopeFaculty of Health and Medical SciencesUniversity of SurreyGuildford

Theresa EllmersDepartment of SociologyUniversity of SurreyGuildford


79

Ingrid EyersFaculty of Health and Medical SciencesUniversity of SurreyGuildford

Martin KnappProfessor, Social Policy, London School of Economics and Political ScienceProfessor, Health Economics, Institute of Psychiatry, King’s College London

Rebekah LuffDepartment of SociologyUniversity of SurreyGuildford

Jim MansellTizard Centre, University of KentCanterbury

Roy McConkeyProfessor in Learning DisabilityInstitute of Nursing ResearchUniversity of Ulster

David McDaidSenior Research FellowHealth Policy and Health EconomicsPersonal Social Services Research UnitLSE Health and Social CareEuropean Observatory on Health Systems and PoliciesLondon School of Economics and Political Science

Helena MedeirosResearch Offi cerPersonal Social Services Research Unit London School of Economics and Political Science

David MorrisProfessor of Mental Health, Inclusion and Community International School for Community, Rights & InclusionUniversity of Central Lancashire

Ann NettenDirector, Personal Social Services Research Unit (PSSRU)University of KentCanterbury

Sayyed Ali SamadiPhD student. Institute of Nursing ResearchUniversity of Ulster

Urvashi SharmaResearch Student (PhD)Department of Information Systems and ComputingBrunel UniversityUxbridge

UNITED STATES

Matthew P. JanickiAssociate Research ProfessorRRTC on Aging and Developmental Disabilities: Health and FunctionUniversity of Illinois at Chicago

Alexandre KalacheSenior Advisor to the President on Global AgeingNew York Academy of Medicine

Juan E. MezzichProfessor of PsychiatryDirector, Division of Psychiatric Epidemiology and of the International Center for Mental Health Mount Sinai School of MedicineNew York University

Michelle PutnamAssistant ProfessorSchool of Social WorkSimmons CollegeBoston

BRIDGING KNOWLEDGE

INDEX> A

Abedalmoti, A 9,14Alonso-Trujillo, F 11,15Arber, S 24Audera, FJ 18Ayuso-Mateos, JL 9,16

B

Balot, J 5Beadle-Brown, J 10,17Beecham, J 17Bendeck, M 5,56Bolancé, C 30Bolibar, B 18Bulbena, A 9

C

Cabanas, M 13,18Cabasés, JM 10,11,34Churchill, J 9,19Cieza, A 10,12,20Clarke, M 62Cope, E 24Cultrera, C 8,21

D

De la Puente, ML 10De los Ríos, A 55Dernovšek, MZ 9,10,22Dimitrov, H 10,11,23Duaigües, M 5

E

Ellmers, T 24Eyers, I 13,24

F

Ferring, D 9,25

G

Garabagiu, A 8,26García-Alonso, C 11,27,48García G, JC 54García-Molina, A 64García-Rudolph, A 64Gibert, K 11,28Gómez-Beneyto, M 11,29

Grandón, P 54Guillén, M 13,30Gyorki, E 19

J

Janicki, M 9,10,31

K

Kalache, A 12,32Knapp, M 5,11,17,34,39Kostanjsek, N 9,12,35

L

Leonardi, M 9,11,36Luff, R 24

M

Mansell, J 17Mayolas, E 9McConkey, R 58McDaid, D 5,9,10,12,37-39Medeiros, H 10,39Mendoza, X 9,40Mestheneos, E 11,12,41Mezzich, JE 10,42Molina, C 11Morales, JM 18Morris, D 12,43Moscarrelli, M 11

N

Nadal, M 68Naue, U 12,44Netten, A 10,45

O

Ondiviela, MA 18Oppenauer, C 11,46

P

Palomar, M 12Parent, AS 5Perdiguer, M 11,47Pérez-Naranjo, L 13,48Poole, M 54,56Prüller, FK 11,49Putnam, M 8,10,50,51

R

Ramos, J 12Raventós, H 10,52Rico, A 12Rincón, A 10Rodríguez-Porrero, C 11,53Roig, T 64Romero, C 13,54,56Ruiz, M 13,55

S

Saldivia, S 54Salinas, JA 54,56Salvà, A 10Salvador-Carulla,L 5,8-10,54,56,57Samadi, SA 13,58Saz-Carranza, A 10,59Schrijvers, G 9,60,61Serra, A 59Sharma, U 13,62Shreck, S 8Solans, J 5,9,63Sprah, L 9,10,22

T

Taltavull, JM 18Ten Geuzendam, J 8Tibaldi, G 11Tirado, P 55Tormos, JM 11,64

U

Üstün, B 12,65

V

Vázquez, ML 11,66Venner, B 9,10,67

W

Walsh, PN 10,68Weber, G 5,9,11,68,69Westerholm, B 9,70Wolfmayr, F 11,71

Z

Zelderloo, L 5,9,11,71,72

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