education for health technology innovation · 2018-10-09 · myocardial infarction (42%) or stroke...
TRANSCRIPT
Education for Health Technology Innovation
Serena Zacchigna, MD PhD
Department of Medical Sciences, University of Trieste
Cardiovascular Biology Group, ICGEB, Trieste
Density of medical schools by region
• Maldistribution, between and within countries
• 36 countries have no medical schools (26 in sub-Saharan Africa)
• Total global expenditure for health professional education: $100 billion per year
(with great disparities between countries), less than 2% of health expenditures
worldwide
The Flexner, Welch-Rose and Goldmark reports
• Integration of modern science into curricula at university-based schools
• Result: doubling of life span during the 20th century
• New infectious risks
• New environmental risks
• New behavioural risks
• New technological risks
Static curricula that produce ill-
equipped graduates do not keep
pace with these new challenges
Informative learning: acquiring knowledge and skills to produce
experts
Formative learning: socialising students around values to produce professionals
Transformative learning: developing leadership attributes to produce
enlighten change agents
- from fact memorisation to searching analysis
and synthesis of information for decision
making
- from non critical adoption of educational
models to creative adaptation of global
resources to address local priorities
- from seeking professional credentials to
achieving core competences for effective
teamwork in health systems
From specialisation to global interdependence in education
Promote interprofessional and
transprofessional education that
breaks down professional silos
while enhancing collaborative
relationships in effective teams
Superspecialization
Department of Medical, Surgical and Health Sciences,
University of Trieste
“From simulation to precision medicine”
(i) simulation and modelling
(ii) big-data analysis
(iii) biomaterials
(iv) international vision
(v) precision medicine
Simulation medicine @ UNITS
Why Do Simulation-Based Training?Simulation-based training gives healthcare providers a new, enlightening perspective on how to handle real-life clinical situations. With
high-realism patient care scenarios that closely simulate genuine crises, participants develop preparedness to both prevent and
respond to critical events. Simulation is poised to help fundamentally change healthcare to meet the challenges of our times.
State-of-the-art manikins
Surgery room
Intensive care room
Heart auscultation
Lung auscultation
Male and female catheterization
Mammary gland examination
Big data analysis: need to introduce
bioinformatic skills in health education
Megabytes (MB)
Gigabytes (GB)
Terabytes (TB)
Petabytes (TB)
EMBL, 2016
Developing innovative therapies for
cardiovascular disorders
Cardiovascular disorders are the most
common, serious, chronic, life-
threatening disease causing more
deaths, disability and economic costs
than all other diseases, including cancer.
More than 1 person out of 3 dies because of cardiovascular disorders, including myocardial infarction (42%) or stroke (36%). The total deaths due to these diseases per year is >17 million peopleworldwide.
More than 50% of patients with ischemic cardiomyopathy develop towards heart failure; there are 15 million new cases of heart failure each year worldwide, a number that is rapidly increasing because of the aging population.
Causes of deathWorld Health Organization, 2011
Global Atlas on cardiovascular disease
prevention and control, WHO 2011
Developing innovative therapies for cardiovascular
disorders
Time line showing the development of drugs against heart failure
Digitalis
Diuretics
Aldosterone antagonists
ACE inhibitors, beta-blockers
1910
1920
1930
1940
1950
1960
1970
1980
1990
2000
2010
Angiotensin II receptor blockers (ARBs)
2020LCZ696?
Novel biotherapeutics for myocardial
ischemia and heart failure
Synthetic peptides or
recombinant proteinsGene Therapy
Protein-coding cDNA?
siRNA? miRNA? Which
vector?Syringe containing factor,
vector or stem cells
Cell TherapyStem cell? Source?
Neoangiogenesis
Myocardial protection
Myocardial regeneration
border zoneinfarct
Global Monoclonal Antibody Therapeutics Market
ShareBy Application (2016)
Biotherapeutics
Screening for cardiomyocyte proliferation
using a library of microRNA mimics
40 human miRNAs increase both rat
and mouse cardiomyocyte
proliferation
hsa-miR-590-3p
48.5%
cel-miR-67cel-miR-67
12.5%
Eulalio et al. 2012. Nature 492, 376
MIControl
MImiR-199a
4 weeksafter MI
Biotherapeutics: need to introduce
business and market skills in health
education
Research
Challenges for bringing biotherapeutics
to the market (in the developing countries)
Zacchigna, 2018, Journal of Biotechnology
• Resistance to accept innovation (poor knowledge on biotechnology)
• Lack of skilled human resources and infrastructure
• Limited financial availability
• Poor governmental support (policies, funding, encouraging investment by the
private sector, international collaborations with advanced centres)
• Lack of appropriate business models (different from small molecule drugs, usually
developed and marketed by big pharmas)
Spin-off universities
Small biotech companies
High level scientific know-how
Intellectual property
Limited financial support
Venture
capitalists
Proof of
efficacy in
early clinical
trials
Large pharmaceutical
companies
2016 2017
Thanks!