– Classification of themes – All

22 Oct The patient, technologies and ambulatory medicine

National Academy of Technologies of France (NATF)
2008
Due to the increased life expectancy and the related increase of chronic diseases (as opposed to acute disorders when patients are younger), an alternative approach to hospital care has become necessary: a third of the population of France and the US now suffers from chronic diseases.  Ambulatory medicine, which is a health care system that keeps the patient at home while offering him the same outstanding quality care that he would receive at the hospital, is such an economically viable approach, responding at the same time to the wishes of patients, to economic requirements and scientific, technological and medical developments. This report describes recent advances of ambulatory medical care, identifies obstacles to overcome and incentives to encourage and makes recommendations for future development with the aim of optimizing the management of healthcare costs, with special emphasis on the role of information technology to master the complex system of information flows between the many stakeholders.  It does also identify the potential hurdles and necessary incentives and looks at issues of compliance with existing law and legal adaptation to the new requirements.  It also evokes the necessary training of the various actors in order for the system to function adequately. Working-group Leaders: Francis Lévi, Professor of Medical Oncology and NATF Fellow, and Christian Saguez, Former Professor at École Centrale de Paris and NATF Fellow.
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22 Oct Individualised Medicine Prerequisites and Consequences

National Academy of Science and Engineering (acatech)
2014
One of medicine’s central goals has been and is to heal, relieve or even prevent patients’ diseases. At the beginning of the 21st century, biomedical research and clinical medicine are undergoing a transformation, described by many as a paradigm shift. New approaches based on genome analyses and biomedical technologies are making it possible to analyse biological processes more precisely and more thoroughly than ever before. Associated with this is the goal of better understanding the causes of disease, providing accurate diagnoses, and last but not least, developing highly effective, precisely targeted therapies that have few side effects. For example, our understanding of why people who apparently have the same illness react differently to the same therapy is growing. ‘Individualised Medicine’ is an approach that adds another dimension to our understanding of illnesses. However, a number of ethical, legal and economic questions are associated with Individualised Medicine. This Statement depicts current developments, challenges and framework conditions of Individualised Medicine.
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22 Oct Incorporating the German Energiewende into a comprehensive European approach – New options for a common energy and climate policy

National Academy of Science and Engineering (acatech)
2017
The working hypothesis underlying the academies’ position paper is that climate protection is the main objective in the efforts leading to a transition of the energy system (“Energiewende”). The statement describes different options for an incorporation of the German Energiewende into a comprehensive European approach. It focuses on the EU emissions trading scheme (EU ETS) as a key instrument for tackling climate change and facilitating European market integration. Furthermore, it describes how the EU ETS could be complemented by measures strengthening the European internal electricity market. Subsequently, the issued recommendations are reviewed regarding their legal feasibility and compliance with European law.
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22 Oct Medical care for older people – what evidence do we need?

National Academy of Science and Engineering (acatech)
2017
In Germany today, reaching a very old age is no longer an exception. About 4.5 million people (5.4 percent of the population) are 80 years of age and older, and their numbers continue to grow. In recent decades, the over 85-year-olds have been the group with the fastest and greatest gain in life span and many positive developments for this growing population group have been recorded. The increasing life expectancy and the improved health of older people over a longer period are also attributable to therapeutic and preventive measures, in addition to other factors. Sick old people, however, may possibly have entirely different medical needs than younger people; this is not sufficiently reflected in the German healthcare system. The high standard in medicine, not only in relation to medical care, but also in research of diseases and the development of therapies, focuses typically on middle-aged patients with a single disease. Accordingly, knowledge gained from the treatment of middle-aged people is frequently also applied for older patients – although they differ both physically and mentally from younger people in terms of their medical care priorities and personal circumstances. This does not comply with good scientific practice, and often leads not only to inappropriate care, but may occasionally also actually endanger the concerned patients. Older people, who frequently suffer from multiple chronic disorders, take many medications at the same time, each of which focuses on one individual ailment. This polypharmaceutical treatment does not at times correspond to the health targets of older patients and may even pose a considerable health risk. There is a lack of external evidence on how to improve treatment for multimorbid older and very old people. There is also a lack of guidelines that indicate the current knowledge gaps and risks. At the same time, important medications are often not offered. Therefore, research to provide specific scientific evidence specifically for older people is absolutely essential. New treatment objectives come to the fore and determine the indication for pharmacotherapeutic, surgical and other interventions: In younger patients cure, restoration of working ability or long-term prognoses determine the course of action. In older patients, these priorities are often replaced by independence, quality of life despite complaints, and the relief of symptoms. The pressure for a quick and effective change to the healthcare situation of older people is growing continuously in line with the rapid demographic change. Physicians, therapists and carers alike must adjust to old and very old people in their daily work – particularly in hospital care. This also applies to basic, advanced and continuing staff training and the cooperation with other health care providers. At all points in the medical care chain, from the lack of scientific evidence to the implementation in practical care, the focus must be on older people and their specific needs.
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22 Oct Academies call for consequences from the Ebola virus epidemic

National Academy of Science and Engineering (acatech)
2017
The Ebola virus is spreading rapidly and to an unexpected extent. The outbreak does not follow the patterns experienced in the past and the virus shows a new disease dynamic in regions, where it has never been recorded before. The German National Academy of Sciences Leopoldina, acatech – the German Academy of Science and Engineering, and the Union of the German Academies of Sciences and Humanities call for the following consequences to be taken: To combat the Ebola epidemic vaccines and antivirals are urgently needed. To meet this need, the further development of experimental vaccines and medicines for clinical application needs to be accelerated. Even if the pathogen should temporarily disappear again, research must continue as a precautionary measure because another outbreak is highly probable. Such precautionary measures must also include ensuring that sufficient quantities of available vaccines and antivirals are stockpiled in case of a new outbreak. Increasing medical and social science research in this area is also vitally important for future preparedness.
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22 Oct On Designing Communication between the Scientific Community, the Public and the Media. Recommendations in light of current developments

National Academy of Science and Engineering (acatech)
2017
Science and journalism are among the essential pillars of a democratic society. Despite their necessary mutual independence and their often divergent purposes, both freedoms also fulfil similar functions. They supply policy-makers and society with a diverse array of information that is as reliable as possible, reinforcing the education and knowledge of the population and stimulating democratic discourse. They should also provide a basis for reasoned political, economic and technological decisions. The academies responsible for this position paper believe that the appropriate exercise of this function is being impaired by a series of developments in the scientific and media systems. For example, the economic conditions in both the media and the scientific community have noticeably changed in recent years. The academies are concerned about the aforementioned development and consider it necessary that the scientific community and the media itself, as well as political decision-makers and society, take a more active role in ensuring the future quality of generally accessible information, including scientific knowledge and its representation in the media. The recommendations expressed in the present policy paper aim to provide food for thought for decision-making authorities and in this way to counter the undesirable developments that have been observed.
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22 Oct Food for All Forever

Danish Academy of Technical Sciences (ATV)
2010
The world population is increasing and with this the amount of mouths to feed. How do we ensure that our food systems are environmentally, economically and socially sustainable; and that the world’s poorest people are no longer hungry? The answer to this enormous question contains the right technological solutions and massive investments in research combined with the right policy directions. The report gives seven elaborated recommendations. Some of the most important are: 1. Use appropriate technology and opportunities offered by science. 2. Massive investments in infrastructure in rural areas to be made. 3. Implementation of better policies that prevent distortions in trade and competition.
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22 Oct Scientific Development of Spin-Offs from Non-University Research Institutes

National Academy of Science and Engineering (acatech)
2010
Innovations have a special significance in knowledge-based economies. The efficient knowledge and technology transfer from research to industry constitutes a decisive factor in the competition between the national economies. The commercial use of information via spin-offs in high-tech sectors plays a key part here. The study on hand on the economic development of spin-offs of non-university research institutes focuses primarily on spin-offs of the four main German research organizations: Fraunhofer Society, Helmholtz Community, Leibniz Community and Max Planck Society. The project was to (1) present the economic development of academic spin-offs on a systematic basis; (2) identify and analyze factors and events that exerted a decisive impact on this development; and (3) in particular, present the significance of early customer involvement for the development of the spin-offs.
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22 Oct Technologies for social development in isolated rural communities

Real Academia de Ingenieria (Spain) (RAI)
2011
Human development and international cooperation. The rural isolated communities. Suitable technologies and innovation for human development. Energy supply. Water and sanitation supplies. Access to ICT and network society services. Agriculture and forests management. Country and Landscape: the essential matrix. Towards an adequate technology to provide rural isolated communities with a basic habitability. Logistic and technology in humanitarian actions. The Spanish organizations and rural isolated communities’ development. Synthesis and outcomes. Sponsors’ point of view.
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21 Oct Population Growth, Climate and World Food Supply

National Academy of Technologies of France (NATF)
2011
This report studies the possibility to adequately feed 9 billion people in 2050, and shows that it is feasible, on certain conditions: - Give priority to the agricultural question among the political concerns of nations and set up ambitious programmes of agricultural development in the poorest countries. - Subsidize, for short periods, certain local agricultural markets, in southern countries whose populations live in self-sufficiency with a small production surplus. - Attenuate the effects of speculation in agricultural markets by better regulation of raw-material futures markets. - Build up stocks to constitute regional, or even family, reserves to avoid the risks of chronic deficits. - Maintain the strong production capacities of European agriculture but redirect it towards healthy and ecologically acceptable food production; - Encourage everybody to eat less animal food products; strengthen regulations governing agro-food industries and collective food preparation; combat waste, currently up to 30% of the production. - Tightly control or ban first-generation bio-fuels which are in direct competition with food production but continue research on 2nd and 3rd generation products. - Create an Observatory for Predicting World Food Situations and Markets to independently observe developments, interpret evolutions, propose hypotheses and scenarios, and anticipate dangers and suggest lines of solution. These recommendations are both for the public authorities and the entire civil society: individual behaviour must primarily change.
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