Tag: care

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Illness duration

The focus in medical analyses is primarily put on the diagnosis of illness. This is the best strategy, if the onset of an illness has a precise beginning and ending. In all processes, where either the beginning and/or the ending is less well-defined as precise point in time, the progression, as phase in or phase out of illness, is also of substantive interest. A duration analysis can inform about the potential presence of a co-morbidity in case, for example, an infection continues beyond the normally expected duration.
Financial pressures in the medical systems makes it necessary to release patients in a timely fashion. Therefore, has become more important to monitor patients even after release from hospital. Digital devices can support such a monitoring.
The study by Josi Levi and co-authors (2026) shows that smartphones or just the monitoring of the number of steps of patient offers a rather reliable indicator on the health status towards the end. The information that a patient has recovered to the normal level of activities as before the onset of the illness works quite well as indicator of recovery. A more precise measure of the duration of an illness is important for patients, care persons, the health system overall. The duration is one of the cost-intensive factors of any illness and it is surprising how little we know about the issue of time and duration in many health processes.

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Polypharmacy issues

As we age, we become more likely to confront polypharmacy issues. Polypharmacy is defined as taking 5 or more medications per day. The study reported in The Lancet healthy longevity by Payne et al. 2025 had participants with a median of 4 health conditions and a median of 8 prescriptions. Even a comprehensive set up which involved several experts from medical doctors and pharmacists did not manage to achieve a significant improvement in polypharmacy outcomes in this experimental study with otherwise carefully matched intervention and control group. However, the mental health (measured in patients as “health-care-related quality of life”) slightly increased and the “treatment burden” experienced by patients was slightly reduced.
In combination with a previous study the probability of errors in nurses, who are the prime persons responsible for the administration of medications in institutionalized settings, the reduction of potentials for errors like they are to be found in polypharmacy should continue to be a prime target of this research in future. Together with the knowledge about the prevalence of functional illiteracy at older ages, polypharmacy remains a critical issue on the public health agenda beyond the experimental settings in this study.

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Unexpected effects

It is, unfortunately, a rare event in science to publish unexpected effects of an experiment. Sometimes, results even turn out to be the opposite of what to tried to show with the use of an experimental setting. The learning for the science community, however, is bigger in such cases. Why? A carefully designed experiment (Oliveira et al. 2025) to measure the effects of 2 different 12 month long yoga trainings to prevent falls in 60+ persons (mean age 67) revealed that the less challenging “seated yoga” was better in preventing seniors from falls.
Participants in the more challenging Iyengar yoga-based sessions reported more falls in the 12 months follow-up period. Due to Covid-19 the trainings took place as an online course, which might have reduced the influence of a coach in correcting positions and observe other physiological or psychological issues with participants.
However, the insights are a great lesson for experiments to produce opposite results of expectations with the lesson that human beings can be rather complex. From a health psychology perspective, it might be the case that participants in the more challenging yoga classed became also more daring in balance as well as other exercises.
Just being overly confident compared to their positive improvements, which might turn around an initially positive effect on balance and falls. From a socio-economic perspective, we would question the implicit assumption of the study that participants have a random distribution or underlying tendency towards risky behaviour. The longer the observation window (post-intervention) is, the more intervening socio-economic factors enter into the physiological-behavioural equation. Hence, expect unexpected effects.

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Inclusive images

In the last 2 decades we can observe a strong concern among photographers to broaden the spectrum covered by images beyond well established imagery of non-binary gender. Diversity in imagery has taken a broader scope to extend, for example, the age range of people who are portrayed as central topic of exhibitions. The topic of mental diversity is more recent and needs a similar or even increased sensitivity to do justice to the whole spectrum of people. The photography of people with mental challenges necessitates a much more careful approach to the persons and complex personalities the photographer intends to portray. Trust and the development of trust of more vulnerable persons is a time sensitive process. The work by Charlotte Abramow “Maurice, Tristesse et rigolade” is a fine example of a photographer who portrayed over a long time of taking care of her father, previously a medical doctor, The years of the final stages of the life course of her father have been the subject over many years as the survivor of an extended medical coma had to struggle with the tough challenge of re-learning basic life skills again.
Abramow portrays her father as an actor of his “second life”, where the borders between reality, reconfigurations of his memories,   and “mise en scene” to co-produce the images. The images go far beyond the portrayal of aging and mental challenges as a deficit of persons. Yes, it is an integral part of these persons, but there is so much fun and positive emotions that derive from the intensive collaboration of actor, father and photographer that the images stick with us for a longer time. The presentation of props along with the photos creates an immersive installation, which strengthens the emotional bonding with the inclusive images of the later phase of the life course of Maurice.

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Humanoid services

In the shadow of AI enhanced chatbots, agentic AI and generative Ai, the developers make considerable progress in robotics. The humanoid versions like from Persona AI will surround us in months, or maybe a few years from today. Investors believe it is rather sooner than later. There are many use cases for humanoids that may take over dangerous, hazardous or unhealthy tasks from humans. But even simple tasks like carrying home most of our shopping could be done for us by humanoids that follow you around the shopping mall and home. This would be a kind of personal assistant. I even thought of my humanoid robot to walk my dog on some occasions on the usual trail. 

Welcoming visitors at the doorstep could be another function to delegate in offices or even in private homes, although as a sociologist I would recommend to carefully check the sorting algorithm(s) applied to avoid unpleasant situations. The administration of medication might be another option, if only we could trust that the correct dosage would be applied. 

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Maison de santé 1861 Berlin

In the middle of the 19th century Berlin was a small city. The area of Schöneberg (pritty hill) was still perceived as the rural outskirts and featured the first botanical garden next to the town center. A little bit more outside of Berlin the “Maison de santé” was founded as early as 1861 to cure mainly respiratory diseases and what later became the first private clinic proposing a new way to treat psychiatric disorders. Dr. Eduard Levinstein was the founder and the clinic had continued its operations for almost 50 years with his wife and sons taking the lead later on. Prof. Wilhelm Griesinger, known for the scientific approach of psychiatry was a proponent of the non-restrained approach to psychiatric disorders, which allowed persons move more freely while being supervised. The documents and the publication (1877) shown in the exhibition at Museum Schōneberg demonstrate the scientific approach to the treatment of addictions, most notably morphine, which had been widely used during the war of 1870 as tranquilizer and pain relief. The wave of addictions needed hospitals and clinics to treat these addictions. The “Maison de santé” had been established as a retreat and cure for other addictions as well. The memory of the early scientific approaches is an inspiring place and reminder to take care of all forms of addiction. Taking care of body and mind is still the state of the art approach today.

The Exhibition catalog is forthcoming, but the visits and material on display of interest beyond the inhabitants of the „Pritty Hill“. Exhibition catalog is forthcoming

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Robot assistant

Adjustment processes on the labour market take their time. This means that care workers are in short supply in most countries of the OECD. Engineers as well. There are so many robots, care robots I mean, still to develop that the shortage of engineers give little hope that we shall have affordable solutions in this area for the next few years. The issue is mainly about integrating and enhancing already existing solutions. If you are a mechanical engineer you can put together motorised mechanical pieces, small motorised electric devices and, for example, small infrared emitting and receiving devises.
All this is child’s play these days (see image below). The assembling of a small Robot assistant that follows movements or can escape from a small labyrinth makes such simple structures transparent for learners and users. There is nothing magical about it, just adding together small pieces and the electronic devices to steer the movements. The learning tool from KOSMOS has been on the market for 5 years. It is a helpful device to explain basics through hands-on experience. The limits of robotics equally become more evident. Our own health and safety is concerned with larger devices cohabiting with us. A robot assistant can take on easy tasks like to follow me through my living space in old age carrying a mobile phone, keys or an emergency device. More sophisticated tasks need more sensors and AI to train the most needed and best routines. For many years this needs our input and our control as well as supervision of such devices. Most robots will operate as assistants with us in the driving seat or the boss.
This is yet another element of the “all electric society“. We are moving towards the use of more electronics assisting us from year to year.

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Obesity Revised

The scientific paper on a revised definition of obesity was produced by the special Commission on Obesity. It appeared in The Lancet Diabetes & Endocrinology in 2025-1. The previously common practice by medical doctors was to classify person in the obesity category based mainly on the simple calculation of the body mass index (BMI = weight/height²). A BMI  > 30 put persons into the obese category and stigma.
Since the Covid-19 society-wide testing experience, we are all familiar what it means if you get misclassified and have to live with the consequences (exclusion from work or events etc.). The simplifying and summarizing BMI calculation and classification has also produced many wrong classifications. For example, persons with a lot of muscles (just watch this at any fitness studio) will have a high weight relative to their body height², but they are likely to be more healthy than many other light weight, but seriously stressed persons.
In empirical test theory such cases are the so-called false positive cases, i.e. classified as obese, but not a medical problem at all. Medical doctors and health insurances should not finance special treatments for these persons, which foregoes treatment of other more needy persons.
With new expensive drugs on the market to treat obesity it is even more important to test with more precision the normal, pre-clinical and clinical status of obesity. Fatty tissue or muscles, that is the relevant question. Fatty tissue in muscles is the next level testing issue.

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Waiting time

A new report by Darzi, a former cancer surgeon and past minister of health in the UK, paints a dismal picture of the British health service (NHS) over the last 15 years under conservative rule. The public service has seen no increase in its budget accounting for population growth and the aging of the population. The service is no longer able “to give patients the timely care they need” (The Guardian 2024-9-12 title page). Increased waiting times lead to an estimated 14.000 premature deaths per year. Darzi presents data that show 300.000 persons had to wait longer than one year for a treatment that should have been performed within 18 weeks.

The staff seems desperate for changes as well as they have to spend more time on management of waiting times, time which is lost for real treatment. The quality of care is another issue which awaits urgent attention. Health cannot wait for most patients, but the neglect of investment in hospitals and people is expensive in the longer run. Even the reform efforts should not wait any longer. Time is a precious good and each life matters. (Image back cover of exhibition catalogue Käthe Kollwitz at MOMA 2024).

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Stroke

A stroke is a very serious medical incident. The NIH defines it in easy language as the the moment in which “blood flow to the brain is blocked or there is sudden bleeding in the brain“. Thanks to a European HORIZON project  forecasting models are produced to estimate the likely incidence until the year 2050 by age and gender within Europe. The good news is major regional imbalances of incidence and mortality have been reduced and will likely be reduced across Europe. The challenge remains the aging of societies which necessitates to address the issue of strokes in each single region of the European Union. We know that the shorter the time to treat a stroke immediately after its occurrence, the better the survival chances and the better the prognosis for (partial) recovery.
In the US the widespread use of blood thinners which tripled over 30 years has not lead to the reduction of intracerebral hemorrhage (Link to studies). High blood pressure and arhythmic heart beat are major causes of this often disabling medical event. The study by Wafa et al. (2024) uses age-pyramids to demonstrate the effect that as European societies are aging the incidence of intracerebral haemorrhage occurs with increasing age and even more so for women than men of 80 years and older.
Prevention of high blood pressure through walking or careful endurance exercise seems even more indicated for an aging society.
Image below from Wafa et al. (2024), The Lancet Regional Health, Europe.