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A technology transfer model for effective HIV/AIDS interventions: science and practice.

The widespread use of effective, science-based interventions to motivate and sustain behavior change provides an important approach to reducing the spread of HIV. The process of disseminating information about effective interventions and building capacity for implementing them in field settings must be improved, however. Starting with a review of diffusion of innovations and technology transfer literature, we offer a technology transfer model for HIV interventions. We identify participants and activities directed toward the use of effective interventions by prevention services providers (e.g., health departments and community-based organizations) in each phase of technology transfer: preimplementation, implementation, and maintenance and evolution. Preimplementation activities focus on selecting an intervention and preparing for implementation. Implementation activities include initial implementation and process evaluation. Maintenance and evolution are ongoing with continued support for and evaluation of the intervention. This article takes the perspective of providers. Other perspectives are presented elsewhere in this issue.

HIV Infections↗

Medical technology transfer in major Chinese medical schools.

This paper examines how the decision-making process and its consequences affect medical technology transfer in major Chinese medical schools. Data are from a 1987 survey of 13 key medical universities, directly supervised by the Ministry of Public Health in the People's Republic of China. This paper limits itself to four types of laboratory equipment--electron microscopes, UV/VIS spectrophotometers, high-performance liquid chromatographs, and polygraphs. Decisions on the transfer of medical technology have been more decentralized in China since the economic reform in 1978. The major reason for schools to import these four types of equipment is their dissatisfaction with the quality of domestic products. Chinese medical schools depend heavily on the information provided at medical equipment exhibits and their neighboring schools. Their decisions to acquire the equipment are based more on the quality and service available than on the prices. Chinese medical schools face serious infrastructure problems in acquiring and maintaining these pieces of equipment. A number of suggestions are made for improving the efficiency of medical technology transfer in China.

China↗

Toxic chemical disasters and the implications of Bhopal for technology transfer.

The dramatic disaster in 1984 at Bhopal, India, may be overshadowed in total impact by less immediate health effects characterized by long latency, cumulative damage, and subtle impairments. Transfer of chemical technology must be accompanied by transfer of the corresponding infratechnology, toxicology, only then can the process of technology transfer be managed with fewer risks, fewer costs, and fewer tragic surprises.

Accidents, Occupational↗

Medical technology transfer in major Chinese hospitals.

The objective of this article is to describe and analyze the decision-making process and its consequences for medical technology transfer in China. Data were obtained in 1987 from 35 elite teaching hospitals affiliated with 13 medical universities, directly supervised by the Ministry of Health in the People's Republic of China. This article focuses on three kinds of diagnostic equipment: computerized tomographs, ultrasonic diagnostic units, and high-power x-ray diagnostic apparatuses. Decision-making on the transfer of medical technology in China is decentralized. Most hospitals rely on foreign medical sales representatives and medical exhibits, and their decisions on the acquisition of equipment rely more on the services available than on the price of the product. Chinese hospitals also encounter serious infrastructure problems when buying medical equipment. A number of alternatives are suggested for improving the efficiency of medical technology transfer in China.

China↗

Tissue culture-based rabies vaccines: vaccine production technology transfer.

Overcoming stagnation in rabies prevention programs in the developing world requires national strategies that include plans to adopt existing facilities for production of low-cost efficacious tissue culture-based vaccine. Transfer of tissue culture technology for the production of rabies vaccine has been supported by the World Health Organization and The Rockefeller Foundation, and in the fall of 1986 the location of the optimal site for the initial technology transfer program was agreed upon. Funds were provided to assemble training staff and to purchase the supplies and equipment to furnish a production facility at the Veterinary Products Company of Colombia (VECOL) located in Bogota, Colombia.

Animals↗

Technology transfer--the rôle of venture capital.

In summary, let me say that the transfer of technology can be managed successfully. In the context of 3i as a whole, we have supported 1600 start-ups in the last five years although, obviously, not necessarily in high-tech industries. In 1987 3i Ventures fully expects to invest a further few million pounds in either start-ups or pre-stock market companies within the health-care and biotechnology sectors. It requires that everyone involved, including the venture capitalist, fulfils their rôle with commitment. It can be a difficult and lengthy process, but it can also be fun and very rewarding.

Industry↗

Cooperative efforts between tertiary-care centers and outlying hospitals boost imaging services and transfer technologies.

Information maintained in the medical record is becoming computerized and is thus accessible to real-time retrieval and correlation. The potential for digital images lies not only in greater diagnostic power, but in the ability to telecommunicate and share the images with all physicians managing the patient, regardless of geographic location.

Cardiac Catheterization↗

Technology transfer of neuroprosthetic devices.

Despite long development periods for neuroprosthetic devices, the numbers in clinical use or clinical trials are rising, with an estimated 3,000 systems in use today. As they gain experience with the regulatory approval process, developers are learning to conduct research to best prepare for transfer of technology to industry. The track record of the first motor prosthesis to be approved by the United States Food and Drug Administration contains important lessons for a company planning to undergo the regulatory process. Throughout the development of a neuroprosthesis, the capabilities and preferences of the customers who will use it (physicians, surgeons, therapists, and end-users) should be sought out and used in device design. When a device has reached clinical application, particular attention is needed to maximize both the population who will use it and each individual's degree of use (optimal, partial, reluctant). Identification of person-technology mismatches can help to select training strategies and other interventions that can be applied to ensure a good rehabilitation outcome.

Clinical Trials as Topic↗

Technology transfer of Network Therapy to community-based addictions counselors.

This paper describes a technology transfer initiative in which Network Therapy (NT), a substance abuse treatment that utilizes peer and family support, was disseminated to a cohort of addictions counselors located in an outpatient community-based addictions treatment center. Training methods included a didactic seminar, role-playing, use of videotaped illustrations, and clinical supervision, and are described in detail. Counselors then implemented the NT approach with a sample of cocaine-abusing patients (N = 10) who were being treated concurrently with the standard program provided by the treatment setting. NT patients were compared by chart review with a cohort of cocaine abusers who received community treatment--as-usual (TAU) (N = 20). The groups did not differ on demographic variables or the amount of TAU received at the community program. However, NT patients had significantly less positive urinalyses than TAU patients, though they were not significantly different in terms of treatment retention. Implications for technology transfer are discussed.

Adult↗

Technology transfer in digital mammography. Report of the Joint National Cancer Institute-National Aeronautics and Space Administration workshop of May 19-20, 1993.

Digital mammography is one of the most promising novel technologies for further improvement of early detection of breast cancer, offering important potential advantages: 1) improved image quality; 2) digital image processing for improved lesion contrast; 3) computer-aided diagnosis for enhanced radiologic interpretation; and 4) teleradiology for facilitated radiologic consultation. The Diagnostic Imaging Research Branch of the National Cancer Institute (NCI) recently funded an international, multidisciplinary, multi-institutional Digital Mammography Development Group for collaborations between NCI, the academic community, and industry to facilitate the integrated development and implementation of digital mammographic systems. Currently, however, digital mammography faces a number of fundamental technological roadblocks: 1) cost-effective digital detectors and displays for imaging systems; 2) the need for novel algorithms for image processing and computer-aided diagnosis; and 3) high performance, low cost digital networks to provide an "information superhighway" for teleradiology. To solve some of these technological problems, the Diagnostic Imaging Research Branch of NCI joined efforts with the Technology Transfer Division of the National Aeronautics and Space Administration to pursue a federal technology transfer program in digital mammography. The authors discuss the findings and recommendations of the workshop entitled "Technology Transfer in Digital Mammography," which was organized and held jointly by the NCI and the National Aeronautics and Space Administration in May, 1993. Numerous innovative technologies of varying degree of promise for digital mammography were presented at the conference. In this article, specific technologies presented at the workshop by the federal and federally-supported laboratories are described, and critiques of these technologies by the leaders of the medical imaging community are presented.

Breast Neoplasms↗

Health promotion technology transfer: organizational perspectives.

This paper explores the relationship between organizational dynamics and program dissemination. Specifically, it is an analysis of factors affecting the directed diffusion of health promotion innovations which target schools and worksites as delivery channels. Technology transfer is the construct which is used to capture this notion of directed diffusion. The term is defined for the purposes of the paper as all strategically planned efforts to promote, influence, or accelerate the natural diffusion or dissemination processes. The paper has three main objectives: first to identify the theoretical perspectives which have influenced my thinking in the area of health promotion technology transfer; second, to describe an organizing framework for the study of health promotion technology transfer; and third, to recommend directions for health promotion planning efforts in the future and the role that research might play in that process.

Child↗

Stabilizing the boundary between US politics and science: the role of the Office of Technology Transfer as a boundary organization.

The sociological study of boundary-work and the political-ecomomic approach of principal-agent theory can be complementary ways of examining the relationship between society and science: boundary-work provides the empirical nuance to the principal-agent scheme, and principal-agent theory provides structure to the thick boundary description. This paper motivates this complementarity to examine domestic technology transfer in the USA from the intramural laboratories of the US National Institutes of Health (NIH). It casts US policy for technology transfer in the principal-agent framework, in which politicians attempt to manage the moral hazard of the productivity of research by providing specific incentives to the agents for engaging in measurable research-based innovation. Such incentives alter the previously negotiated boundary between politics and science. The paper identifies the crucial role of the NIH Office of Technology Transfer (OTT) as a boundary organization, which medicates the new boundary negotiations in its routine work, and stabilizes the boundary by performing successfully as an agent for both politicians and scientists. The paper hypothesizes that boundary organizations like OTT are general phenomena at the boundary between politics and science.

Biotechnology↗

The federal role in drug abuse technology transfer: a history and perspective.

The past 30 years have seen a focus on substance abuse research in association with the creation of federal agencies specifically mandated to guide that effort. While research has been well supported and largely productive, there has been increasing concern with the slow pace of adoption of the findings from that research. The history of those efforts suggests a long-standing concern with knowledge development, and a continuing reliance on print media to achieve knowledge application. Nonetheless, evidence from other human service fields, and increasingly from the substance abuse field, indicates interpersonal strategies are dramatically more effective in achieving the individual and organizational behavior change needed to achieve technology transfer. Argument is made that the federal government remains the best, if not the only resource for promoting technology transfer. A paradigm is described to further federal efforts in this area, and structural elements suggested for the achievement of technology transfer goals.

Government↗

A case study in innovative outreach--combining training, research, and technology transfer to address real-world problems.

Outreach, training, technology transfer, and research are often treated as programmatically distinct activities. The interdisciplinary and applied aspects of the Superfund Basic Research Program offer an opportunity to explore different models. A case study is presented that describes a collaborative outreach effort that combines all of the above. It involves the University of California's Davis and Berkeley program projects, the University of California Systemwide Toxic Substances Research and Teaching Program, the U.S. Navy's civilian workforce at the former Mare Island Naval Shipyard, Vallejo, California (MINSY), a Department of Defense (DoD) Environmental Education Demonstration Grant program, and the Private Industry Council of Napa and Sonoma counties in California. The effort applied a Superfund-developed technology to a combined waste, radium and polychlorinated biphenyl contamination, stemming from a problematic removal action at an installation/restoration site at MINSY. The effort demonstrates that opportunities for similar collaborations are possible at DoD installations.

California↗

Health care contracts in Britain and the United States: a case for technology transfer?

One unexpected point of convergence between the British and North American health care systems is the increased use of negotiated contracts to govern relationships between purchasers and providers. In Britain, the internal market reforms introduced a special regime of National Health Service (NHS) contracts; in the United States there has been a move from disorganization towards integration with the emergence of larger purchasing coalitions and provider organizations. While, in the past, US patients were simply billed for services or assigned claims to the provider, it is now common for payment to be made directly from purchaser to provider and for the terms of these transactions to be set out in contracts. This paper draws on the reading of contracts, interviews with contracting parties, and ongoing research on NHS contracting in Wales to compare contracting practice within the two systems. It examines how the very different environments of the public, hierarchically-regulated NHS and the private health care market of the US influence the detailed content of contract clauses. The analysis passes over similarities, different solutions to common problems, and fundamental differences of approach, before considering the possibilities for transfers of contracting 'technology'.

Contract Services↗

Quantitative management techniques in dietetics: improving practice through technology transfer.

A content analysis of articles appearing chronologically in the Journal of The American Dietetic Association since its inception in 1925 reveals the breadth and depth of management practice in the dietetic profession. This historical review highlights the introduction, demonstration, and adoption of management tools and techniques in the profession, with particular emphasis on quantitative management science techniques. Seven classifications of management science techniques were used for the content analysis. Although applications of forecasting, simulation, linear programming, and queuing models have been reported in the Journal, a gap is evident between the demonstration of management science techniques and operational use of these techniques in dietetic practice. Dietetic researchers, practitioners, and educators have vital roles in facilitating the transfer of quantitative management science technology into operational dietetic practice. Assessment of the state-of-the-art of dietetic management practice relative to proven quantitative management science techniques reveals the need for improved technology transfer to enhance professional ability in both tactical and strategic decision making.

Dietetics↗