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Histoplasma capsulatum, the best fungal model for studying intracellular parasitism, is now becoming a model system for evaluating the molecular basis of virulence. This brief review summarizes the available tools and emerging techniques for molecular genetic studies of H. capsulatum and related fungal pathogens.
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In the context of its technology transfer programme, the European Space Agency (ESA) has decided to examine in greater detail the medical applications of space technological developments. There are several sectors in which space technologies have already been successfully used in biomedical apparatuses, in Europe and in North America. The ESA has therefore set up a team designed, among other things, to promote exchanges between the space industry and the world of medicine. Encouraging results have already been obtained and the medical sector shows an increasing interest in this initiative, particularly in the fields of surgery, anaesthesia, radiology and telemedicine. The ESA therefore envisages the creation of a nonprofit association to extend the actions which it has carried out experimentally over the last two years to the whole of Europe and to all medical disciplines.
Technology, as applied in healthcare, is an encompassing term for products, equipment, procedures and services allied in some way with healthcare. This paper discusses technology as the word applies to healthcare. Areas of activity under the umbrella of technology--technology transfer, technology assessment and technology management--will be defined and discussed from the standpoint of their interaction with clinical engineering. The clinical engineering profession has approached participation in each of these activities in a nonsystematic manner, resulting in limited impact and a limited role. To go beyond its present role, the profession must study the processes of technology assessment, transfer, and management to understand their components, critical paths, strengths and weaknesses. This research should be undertaken by a joint group of clinical engineers representing practitioners and academia. Existing key players or professions should be identified, the role clinical engineers wish to pursue as a professional group and the skills required to assure competency should be declared, and appropriate resources for acquiring knowledge and experience identified.
Application flows naturally from good science, and behavioral toxicology is no exception. Phenomena discovered and procedures developed in behavioral laboratories are being applied on a wide scale in commercial, industrial, and governmental settings. In behavioral toxicology, this transfer of technology has occurred in an ad hoc manner, albeit with a degree of sophistication. The development of technology transfer in other disciplines is instructive. A symposium at the May 2001 meeting of the Behavioral Toxicology Society examined this issue, and some participants provide their contributions here. Henry Pennypacker examines the issue of whether behavioral procedures can meet the demanding standards required to transfer technology to commercial endeavors and concludes that, under some conditions, they can. He notes that the shortage of well-developed and transferred behavioral technologies results from a lack of understanding of the process of technology transfer on the part of behavior analysts. In the field of engineering, the results of basic research are transformed to candidate technologies that meet standardized criteria with respect to three properties: quantification, repetition, and verification. Kent Anger describes the challenging steps in the trail from the laboratory to wide-scale application-steps that are essential for the scaling up of any behavioral technique. Finally, Paul Mele describes the legal background to patenting and copyrighting ideas, a process that behaviorists have rarely used. Together, these topics identify the requirements and warn of the challenges and intricacies that await those who seek to transfer behavioral technology beyond the laboratory.
The important challenge of prevention and control of rabies in the world will require international efforts to increase the availability and use of high quality cell-culture rabies vaccines for use in man and animals. An important aspect of activities to ensure such availability is transfer of technologies to developing countries for production of these vaccines. This article, which is based on the report of a WHO Consultation, outlines the technical options for vaccine production. The principles and economic aspects of technology transfer are considered, and a WHO assistance programme is outlined. It is concluded that technology transfer should be mediated through a framework of national institutes, expert panels, WHO collaborating centres, production and control laboratories, and other relevant institutions. On this basis, recommendations are made concerning the mechanisms of technology transfer for production of cell-culture rabies vaccines.
The treatment of haemophilia in both the developed and developing world countries need not be complicated. The person with haemophilia can be treated and managed by common sense and the application of basic knowledge and understanding of the physiology and pathology. Emphasis needs to be placed on training people rather than on technology in the areas of clinical medicine, laboratory medicine and blood transfusion medicine. Within these specialties, there are a number of practical aspects in which a critical degree of expertise is required. Such expertise may not be available in the developing country and hence there is a very justifiable reason for the exchange of knowledge, technology and goodwill.
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The newly independent nations of the former Soviet Union continue to restructure and refine their political and economic environments. Competition for scarce of dwindling economic resources within these nations and between the nations of an expanding global community necessitates that they adopt more efficient and effective management methods to provide essential public services. As a result, organizational management concepts developed and used in the West (i.e., in the United States and the countries of the European Union) are eagerly sought for incorporation into new administrative systems. This is an opportune time for healthcare service management educators to develop and present total quality management (TQM) programs, stressing continuous quality improvement (CQI) methods specifically targeted and adapted to the organizational needs of these countries, as they restructure their societies from centrally planned to market-driven economies. In general, educators in healthcare service management, acting as information consultants, can play a pivotal role in guiding strategies for healthcare organizational change and in helping to stabilize transitional organizational processes, by providing guidelines that can improve utilization of healthcare resources and monitoring of healthcare service outcomes. Most of the observations and recommendations presented in this article are derived from the author's experiences in conducting healthcare management improvement projects in Bulgaria in 1993 and in Lithuania since 1991.
On November 13 and 14, 1996, a scientific symposium on oral rehydration therapy (ORT) was held at the Johns Hopkins University School of Hygiene and Public Health in Baltimore, MD. The purpose of the meeting was to review the current treatment practices for the treatment of this disease in the United States. The group noted that diarrhea resulted in 300 to 400 deaths per year among children, approximately 200 000 hospitalizations, 1.5 million outpatient visits, and costs >$1 billion in direct medical costs. ORT is well established therapy for the treatment and prevention of dehydration due to diarrhea. The principles of ORT treatment include early adequate rehydration therapy using an appropriate oral rehydration solution (ORS), replacement of ongoing fluid losses from vomiting and diarrhea with ORS, and frequent feeding of appropriate foods as soon as dehydration is corrected. The effective use of ORT has saved millions of lives around the world. However, in the United States, ORT is grossly underused. Contrary to the recommendations of the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC), health care providers overuse intravenous hydration, prolong rehydration, delay reintroduction of feeding, and inappropriately withhold ORT, especially with children who are vomiting. The expert panel noted that the majority of deaths, hospitalization, and visits to emergency departments could be prevented by the appropriate use of ORT. They generated guidelines for the treatment and prevention of dehydration secondary to diarrhea. These measures, together with training providers, could substantially reduce diarrhea mortality and decrease hospitalizations of children by 100 000 per year in the next 5 years.
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