The NZ Ministry of Tourism has only just acknowledged that Baby Boomers and older people are already the most important domestic market, and their own data shows that this group is also the most important international market. And the older market is going to increase in size. In spite of this, the NZ government and industry are not planning for this changing – and richer – market. Instead, NZ goes after the young, and after adventure seekers. This is in spite of the fact that top holiday motivators for visitors to or within NZ tend to be fairly sedate. For internationals, “seeing attractions”, and for domestics “taking time out” top the list. In fact the number one activity of all tourists in NZ is “sightseeing”. While it is true that some of older tourist will still want to jump off bridges or hang off mountains, most will probably be less inclined to do so as they age and become less able-bodied. And it is the disabled and growing ageing sector that NZ should be going after. Why? Because people with disabilities already would spend more on tourism, travel, and hospitality if truly accessible services were available to them and it is also because as Boomers age, they will demand accessible products.

The conference will look at various aspects of Access Tourism, including some of the following: the current situation in NZ and worldwide, website access and information best practice, government strategy, policy, and obligations, best practice in transport, accommodation, and attractions access, training for access in the tourism and hospitality sector, legal aspects, and quality rating for Access Tourism products in New Zealand. It will also include brainstorming sessions on strategies for advancing the development of Access Tourism in New Zealand and developing collaboration as a tool to advance that development. These topics are based on those most popularly picked from a list of possible topics in an online survey. The conference is being run by the New Zealand Tourism Research Institute at Auckland University of Technology. Further information and details of registration can be found on the Research Institute website.

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A unique device based on sniffing—inhaling and exhaling through the nose—might enable numerous disabled people to navigate wheelchairs or communicate with their loved ones. Sniffing technology might even be used in the future to create a sort of “third hand” to assist healthy surgeons or pilots.Developed by Prof. Noam Sobel, electronics engineers Dr. Anton Plotkin and Aharon Weissbrod, and research student Lee Sela in the Weizmann Institute of Science’s Department of Neurobiology, the new system identifies changes in air pressure inside the nostrils and translates these into electrical signals.

The device was tested on healthy volunteers as well as quadriplegics, and the results showed that the method is easily mastered. Users were able to navigate a wheelchair around a complex path or play a computer game with nearly the speed and accuracy of a mouse or joystick.

Video available here.

via News Releases: American Committee for the Weizmann Institute of Science.

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New data presented at the International Conference on Alzheimer’s Disease (ICAD): Effectiveness and beneficial effects of AXURA® / AKATINOL® (Memantine)
Honolulu, Hawaii – [July 15, 2010]

Has the role of non-pharmacological treatment (NPT) in the management of Alzheimer’s disease (AD) been over-estimated? Study results discussed at the International Conference on Alzheimer’s Disease (ICAD) suggest that patients with AD did not benefit from additional NPT e.g. occupational / physiotherapy and cognitive training compared to patients receiving Memantine monotherapy. The data of two recent non-interventional studies support that AXURA® / AKATINOL® – an uncompetitive NMDA receptor antagonist – is effective in the treatment of moderate to severe AD and provides beneficial effects on caregiver time. Another positive aspect for Memantine is related to rising health care costs discussion.

Alzheimer’s disease (AD) leads to increased cognitive, communicative and functional deficits and behavioral disturbances. Therefore the patients’ needs are complex. The decline associated with the progressive disease also places a considerable burden on caregivers and the health system. For the treatment of AD regimens including pharmacological and non-pharmacological therapies (NPT) are used. Due to International Treatment Guidelines for Alzheimer’s disease the management of AD should focus on an evidence-based antidementia treatment strategy. Placebo-controlled, double-blind, randomized clinical trials, metaanalyses (1) and responder analyses (2) show the efficacy and tolerability of Memantine in moderate to severe AD. But reliable conclusions for the potential benefits of NPT are difficult to draw.
The efficacy and costs of Memantine and concomitant NPT in patients with moderate to severe AD in everyday clinical practice were investigated in an observational study in Germany. (3) The results of this one year outcome research study including 872 outpatients with moderate to severe AD show that non-pharmacological therapies provided no statistically significant benefit in combination with Memantine treatment compared to standard Memantine monotherapy. On the other hand average costs exceeded those of patients with monotherapy by 49% (annual average costs amount 5.066 Euro per patient vs. 3.410 Euro). In this study two cohorts of patients were observed (mean age 77 years, 59% female). Cohort “pure” includes 401 patients receiving Memantine treatment alone. Cohort “plus” compassed 471 patients treated with Memantine and NPT. Assessments during the observational period were at the beginning, after 3 and 12 months Barthel Index, Nurses Observation Scale for Geriatric Patients (NOSGER), Minimental State Examination (MMSE), Clinical Global Impression of Change (CGI-C) and quarterly, cost related parameters. Patients were treated for one year with Memantine (Axura®); median dose of Memantine was 20 mg Memantine / day. The most frequently initial NPTs were occupa-tional/physiotherapy (54%) and cognitive training (23%). There were a total of 70 different therapeutic regimens. At the end of the one year observational period additional clinical benefits of NPTs were low and the outcome results were not significantly superior to memantine monotherapy. AXURA® / AKATINOL® has once again been proven as a safe and tolerable treatment option in Alzheimer’s patients in a “real world” setting.
In another non-interventional study of Memantine in nursing home residents with AD Memantine has proven beneficial effects on caregivers time: Caregiver time was reduced or stabilized for 94% of patients during the 24 week observational period. (4) At the end of 24 weeks, mean daily caregiver time was reduced by 12.14 (+ 37) minutes. 27.8% of caregivers could save up to 2 hours / day. Data from 1.325 patients (70% female, mean age 79 years) with moderate to severe AD were analyzed in the total safety set. Data for caregiver time was documented for 1.124 patients. Median caregiver time spent at the beginning was 148 minutes. 91% of caregivers spent up to 4 hours / day for the patient’s care. Patients were treated for 24 weeks with Memantine (Axura®), mean dose of Memantine was 18.33 (+ 5) mg / day. Patient’s abilities were assessed at the beginning of the study, and at weeks 4, 8, 12 and 24 using MMSE, the Functional Assessment Scale (FAST), NOSGER and CGI-C. Furthermore, relevant parameters for the care of patients were assessed: at the beginning, the nursing care level and the time spent for patients care by caregivers. The change of caregiver time was documented during the observational period. The majority of patients in the group “caregiver time saved” showed improvement in MMSE total score and improvement or stabilization of their functional abilities measured as change of FAST stage. These findings were in accordance with physicians’ clinical evaluations. Patients with reduced or stabilized caregiver time showed a statistically significant reduction of NOSGER total score over 24 weeks treatment with Memantine. The change of CGI-C was judged as improved in 79.2% of patients and stabilized in 14.2% of patients.
The Alzheimer’s Society is concerned that antipsychotic drugs are being over-prescribed to people with dementia. (5) About 90% of patients with AD experience hallucinations, paranoia, agitation and aggressive behavior. Although associated with serious adverse events, antipsychotics are frequently prescribed as first-line pharmacological treatment for neuropsychiatric symptoms. A study group investigated the use of antidementia drugs (ADDs) and of antipsychotics (APs) in patients with incident AD in the UK. The findings of this analysis: At initiation of AD treatment, a larger proportion of patients treated with Memantine compared with acetylcholinesterase inhibitors (AChEIs) are on AP-therapy. This possibly reflects the different registered indications, and/or that physicians preferentially use Memantine in AP treated patients due to its well-known treatment effects on behavioral disturbances in AD patients
Data source of this analysis was the primary care UK General Practice Research Database (GPRD). The cohort included patients 60 to 90 years with at least 182 days eligibility in GPRD, and with newly diagnosed AD. AD was defined by the earliest entry of an AD recording and prescription of an antidementia drug, either AChEI or Memantine. The incident AD cohort comprised 8.510 patients with 3.664 (43.1%) completing at least 24 months of observation. The proportion of females was 66.9%, predominantly in age 80 to 89. While 4.693 (55.1%) remained untreated during the entire observational period, 3.817 (44.9%) in the AD cohort were given AChEI and / or Memantine. Of those treated, 3.698 patients (96.9%) were initially given AChEI, 115 (3.0%) Memantine and 4 (0.1%) AChEI and Memantine. The median duration from incident AD to the first AChEI and Memantine prescription was 1.9 and 7.6 months respectively. In the AD cohort, 12.5% (1.065/8.510) of patients were given APs in the 182 days prior to AD and 30.1% during the observational period. At initiation of AChEI treatment 10.7% of patients had used APs in contrast to 18.3% at initiation of Memantine treatment. AP use among switchers from AChEI to Memantine was 23.7%.
Dementia is a progressive, degenerative brain syndrome that affects memory, thinking, behavior and emotion. Dementia knows no social, economic, ethnic or geographical boundaries and affects people throughout the world. When dementia progresses affected individuals need care with all aspects of daily life, world-wide mostly families provide this care. Alzheimer’s disease is the most common cause of dementia and accounts for 50-60% of all cases and is caused by abnormal brain tissue changes. International studies make it clear that dementia occurs in every country of the world. Dementia affects 1 in 20 people aged 65 plus and 1 in 5 aged 80 plus. Worldwide there are an estimated 30 million people with dementia. By 2050 the number will rise to over 100 million. (6) Alzheimer’s disease affects 5.3 million people in the U.S. and is the 7th leading cause of death. AD causes 172 billion dollars in annual costs and puts a heavy burden on 10.9 million unpaid caregivers. (7) In light of this, drugs like AXURA® / AKATINOL® may represent an impactful treatment choice to efficiently face this socioeconomic challenge.
References
1 Winblad et al., Dement Geriatr Cogn Disord 2007, 24: 20-27
2 Wilkinson & Andersen, Dement Geriatr Cogn Disord 2007, 24: 138-145
3 Sallach et al., Effectiveness of memantine and non-pharmacological concomitant therapies in patients with moderate Alzheimer’s disease. Poster presented at the 10th Alzheimer’s Association International Conference on Alzheimer’s Disease (Alzheimer’s Association ICAD), July 2010, Hawaii
4 Riepe et al., Beneficial effects of memantine on caregivers time – results of an observational study in moderate to severe Alzheimer´s disease. Poster presented at the 10th Alzheimer’s Association International Conference on Alzheimer’s Disease (Alzheimer’s Association ICAD), July 2010, Hawaii
5 Alzheimer’s Society, www.alzheimers.org.uk
6 Rietbrock et al., Alzheimer’s disease and use of antipsychotics in the UK. Poster presented at the 10th Alzheimer’s Association International Conference on Alzheimer’s Disease (Alzheimer’s Association ICAD), July 2010, Hawaii
7 Alzheimer’s Disease International (ADI), www.alz.co.uk
About Memantine
Memantine is an NMDA-receptor antagonist, the first in a class of AD medications with a unique mechanism of action that focuses on the glutamatergic system. Glutamate is the most common excitatory neurotransmitter in the CNS and the modulation of the glutamatergic neurotransmission is a major target for the treatment of Alzheimer’s disease.
Memantine was developed by Merz and licensed to Forest for the U.S. and Lundbeck for selected European and international markets. Memantine is marketed under the brands Axura® and Akatinol® by Merz, Namenda® by Forest and Ebixa® by Lundbeck.
Merz Pharmaceuticals GmbH (www.merz.com):
Merz Pharmaceuticals, as a member of the Merz Group companies, is an innovative and international healthcare company specializing in the research, development and marketing of pharmaceuticals for the treatment of neurological and psychiatric diseases. Merz is a leader in the field of Alzheimer research and developed memantine as the first drug for the treatment of moderate to severe Alzheimer’s disease. Other franchises covered by Merz are hepatology / metabolic diseases and dermatology.
Contact:
Dr. Jasmine Fokkens
Merz Pharmaceuticals GmbH
Tel.: +49 (0)69 / 15 03 – 804
Fax: +49 (0)69 / 15 03 – 722
E-mail: jasmine.fokkens@merz.de

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In this report from the Times in South Africa about 2000 doctors are facing negligence claims. The claims are predominantly in the public sector.

Most claims arise from cosmetic surgery and child care / birthing procedures.

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Nordic Capital Fund VII acquires Handicare

Oslo, June 2nd 2010 – Nordic Capital Fund VII has acquired the healthcare company Handicare from the Herkules Private Equity Fund. – Nordic Capital has a strong funding base, industrial expertise and international experience, all of which are important to ensuring the further growth of Handicare, says Per Gunnar Borhaug, CEO of Handicare.

Handicare, which provides technical aids for the elderly and disabled, has grown substantially over recent years, increasing its turnover from 650 million NOK in 2005 to 2.5 billion NOK in 2009. During that same period Handicare acquired 12 other companies and has become the European market leader within its industry.

- Our partnership with Herkules has been very good throughout and characterised by expansion and growth. With Nordic Capital Fund VII as our new owner, Handicare’s foundation for further growth and expansion will be strengthened, says Per Gunnar Borhaug, CEO of Handicare.

Herkules Private Equity Fund, a Norwegian investment fund, became Handicare’s major shareholder in 2005. Nordic Capital Fund VII will now, together with management, own 100% of the shares in HC Holding AS – the holding company of Handicare.

- We are impressed by what the management team at Handicare has achieved in co-operation with Herkules Capital over the last five years, says Fredrik Näslund, partner at Nordic Capital. We see great potential for further growth and are looking forward to working closely with the management team to further strengthen Handicare’s position in a growing market.
- It has been exciting for us to contribute to the development of Handicare, now a leading European player, and the investment has resulted in good returns on equity during our partnership, says Morten Blix, partner at Herkules Capital. Handicare’s continued strategy of further growth requires additional funding, and this is the right time for us to exit the company. We are convinced that Nordic Capital will prove an excellent owner and partner for Handicare.

For more information, please contact:
Per Gunnar Borhaug, CEO, Handicare +47 69 24 45 14
Morten Blix, Partner, Herkules Capital, +47 92 80 18 24
Fredrik Näslund, Partner, Nordic Capital +46 70 653 60 80

Update:
(Editor – be sure to read The Return Of The (Homecare) Vikings which is as relevant today as it was 5 years ago when it was written).

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**Save $400 when you register by THIS FRIDAY, April 30. To qualify, contact World Congress at 800-767-9499 with code ZNA639, not applicable to government registration.**
For more information, visit: www.worldcongress.com/europe.

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Moss, 12 April 2010 – Handicare AS has acquired 100% of the shares of KWS Rehab AS and strengthens thereby its position within the accessibility market.

The healthcare company Handicare offers a complete product range of technical aids to the Norwegian market. Through its Home Care division stairlifts, lifting platforms and other accessibility products are supplied both to the reimbursement market through NAV as well as to the institutional- and private market. The Handicare organisation is present in all parts of Norway offering sales, installation and service. The company has through many years been developing and selling its own lifting platform (Columbi) and the last years Handicare has strengthened its position and product offering further by acquiring the stairlift manufacturers Freelift BV (2007) and Minivator Ltd (2010). In 2009 the accessibility concept “Com-in” was launched towards the private market.

The company KWS was established in 1996 and is operating within sales and project management of accessibility products to the contractor-, private- and NAV-markets in Norway. The company is based in Langhus at the outskirts of Oslo, has 7 employees and a turnover of approx. 15 million NOK. KWS is today distributor for recognized suppliers and has until now been distributing Freelift stairlifts in Norway.

The purpose of the acquisition is to acquire more know-how and to get access to a larger product assortment within the accessibility market. The company will be included in the Handicare Home Care division where a centre of competence will be established focusing on product management and technical competence. The target is to be the preferred supplier of a complete range of accessibility products to the contractor-, private- and NAV-market in Norway.

For more information contact Mr. Jørn Horgen at KWS mob. +47 913 45 206 or Johan Aas at Handicare mob. +47 909 69102.

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