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PubMedDate not supplied

Assistive technology and learning disabilities: today's realities and tomorrow's promises.

Many forms of technology, both "high" and "low," can help individuals with learning disabilities capitalize on their strengths and bypass, or compensate for, their disabilities. This article surveys the current status of assistive technology for this population and reflects on future promises and potential problems. In addition, a model is presented for conceptualizing assistive technology in terms of the types of barriers it helps persons with disabilities to surmount. Several current technologies are described and the research supporting their effectiveness reviewed: word processing, computer-based instruction in reading and other academic areas, interactive videodisc interventions for math, and technologies for daily life. In conclusion, three themes related to the future success of assistive technology applications are discussed: equity of access to technology; ease of technology, use; and emergent technologies, such as virtual reality.

Computer-Assisted Instruction↗
PubMed1994

Can technology assessment control health spending?

Because medical technology is the most important controllable component of health spending growth, the success of strategies for limiting spending growth depends upon their impact on technology dissemination. Technology assessment is fundamental to any strategy for controlling the adoption of medical technologies. Cost-effectiveness analysis holds particular promise as a method for evaluating alternative health care technologies because it explicitly incorporates costs. This paper describes how the widespread adoption of health insurance promoted the dissemination of medical technologies and how technology dissemination fueled spending growth. It then describes approaches to technology assessment and the ways in which technology assessment, in the form of cost-effectiveness analysis, can be applied to help control spending growth.

Cost-Benefit Analysis↗
PubMed1993

Health care technology: how can we tell if we can afford it? A Canadian viewpoint.

Major changes are reshaping the economic, political, and social climate in which Canada's health care systems operate. Cost containment has become an essential element of that climate. The perception is that health care technology is a major contributor to health care costs, and this has served as the impetus for a call for assessment and evaluation of all health care technology. While the need for health technology assessment is valid, such assessments must be much broader than simple economic assessments. A complete cost-benefit analysis of the clinical use of a given technology, including consideration of possible alternatives and the implications of rejection of that technology in certain circumstances, is complex. If we are to utilize the results of these analyses to effect important changes in health care delivery, studies must include the science behind the technology, the technology itself, the devices resulting from the technology, the medical outcome, and the societal impact in addition to pure cost considerations. Only then will we be able to properly assess the effectiveness and efficiency of health care technology in society and decide whether we can afford it.

Canada↗
PubMed1985

Automated microbiology systems. An ECRI technology assessment.

Microbiology is the last of the major labor-intensive sections remaining in the clinical laboratory; other large, previously labor-intensive areas--chemistry and hematology--were automated over the last two decades. Only in recent years has technology been developed to permit automation of microbiology techniques. This assessment describes the historical development and technological aspects of automated microbiology systems. Patient care can be improved by earlier treatment and reduced lengths of stay when clinicians use the rapidly reported information provided by automated microbiology systems. Automated systems may reduce the cost of microbiology testing; whether savings are realized depends both on the manual methods to which the automated technology is compared and also on the particular automated system under consideration. Some studies indicate that the technology is cost saving when used on a large scale; other studies show that, while automated microbiology technology extends laboratories' capabilities, the technology can increase laboratory testing costs. Since automated microbiology systems cannot result in cost savings in every application, it is a technology that should be carefully evaluated in its intended setting, before a decision is made to acquire such a system. Adoption of the technology in hospital laboratories has been relatively limited; problems in perfecting the technology have slowed its acceptance. In states with prospective payment systems in place prior to 1983, hospitals' acquisition of automated microbiology systems has been even more limited.

Autoanalysis↗
PubMed2004

New technology and its impact on well being.

Great changes have come about in the last decade regarding the organization of work. High technology and the steadily increasing ideology of technocracy has produced a profound effect on the organization of work in some workplaces. This effect has made the psychosocial and physical working environment tougher, especially for women. The results we are presenting here show that when dividing fishing factories into three technological stages; low technology, middle technology and high technology, the job strain was highest and the decision authority by the employee was lowest in the high technological factories. This even had an impact on health and on the atmosphere at the workplace, where the employees in the high technological factories were more likely to complain about several health problems as well as about low degrees of cheerfulness at the workplace and tiresome jobs. However, these same people were the most positive towards the implementation of the high technology and the new way of organizing their job that the technology introduced.

Animals↗
PubMedDate not supplied

PACS storage technology update: holographic storage.

This paper focuses on the emerging technology of holographic storage and its effect on picture archiving and communication systems (PACS). A review of the emerging technology is presented, which includes a high level description of holographic drives and the associated substrate media, the laser and optical technology, and the spatial light modulator. The potential advantages and disadvantages of holographic drive and storage technology are evaluated. PACS administrators face myriad complex and expensive storage solutions and selecting an appropriate system is time-consuming and costly. Storage technology may become obsolete quickly because of the exponential nature of the advances in digital storage media. Holographic storage may turn out to be a low cost, high speed, high volume storage solution of the future; however, data is inconclusive at this early stage of the technology lifecycle. Despite the current lack of quantitative data to support the hypothesis that holographic technology will have a significant effect on PACS and standards of practice, it seems likely from the current information that holographic technology will generate significant efficiencies. This paper assumes the reader has a fundamental understanding of PACS technology.

Education, Continuing↗
PubMed1991

Assessment criteria for diagnostic imaging technologies.

Expensive diagnostic imaging technologies need to be assessed. Assessment is most difficult with new technologies. Rapid technical change creates pressure for widespread provision because of apparently self-evident advantages. For the health care provider, technology assessment is of central importance. Timing is crucial; economic and clinical studies have to be carried out simultaneously; and studies must be broadly based. Assessment should be carried out only on properly selected technologies. Apart from picture archiving and communication systems, existing expensive diagnostic imaging technologies are now so mature that assessment is concerned mainly with costs and benefits. To be provided, a technology needs to be effective, economic, appropriate and needed. The history of computed tomography illustrates technology assessment from innovation to routine application. Technology assessment also provides essential guidance for equipment selection. Different regulations and controls, explicit or implicit, exist in different countries. There are special requirements for technology assessment in each country according to overall health requirements and policies. The main contemporary challenges are the correct selection of equipment for assessment, and the development of predictive methods of assessment.

Diagnostic Imaging↗
PubMed1998

Impact of technology on costs and patient outcome.

Technology is only as effective as the clinicians who employ the technology and the system in which they function. For any technology to change patient outcome, or be cost effective, clinicians must be educated and incented to change their practice. At this point in American health care, technology appears to vary widely in the effectiveness in which it is employed. Research consistently decries the lack of effective use of technology. Some authors have claimed this lack of consistent use of technology is near a crisis proportion, both in terms of the costs and impact on patient outcome. The wide variability in technology application is understandable owing to the lack of a unifying approach to the application, education, and evaluation of technology. Only when we have an organized system, lead by professional societies, will technology usage achieve standardization. Until that time, individual hospitals need to follow guidelines like the ones presented in this article to ensure patients are receiving optimal and cost-effective care.

Critical Care↗
PubMed1998

Technology for health in the future.

Developments in biogenetics, medical devices, information and communication technologies, and in environmental technologies will have a profound impact on health in the coming decades. However, there are major barriers to the appropriate and effective utilization of current and future technologies, particularly for developing countries. This paper intends to strike a balance between the exciting potential of technologies and the conditions that need to be fulfilled to ensure that technologies are utilized appropriately and effectively. It will emphasize the significance of knowledge associated with technologies, the importance of technology assessment and the need for a broad and comprehensive technology management policy.

Forecasting↗
PubMed2005

Essences and imperatives: an investigation of technology in childbirth.

This paper explores the connection between our cultural inclination towards technology, the nature of technology itself, and birthing women's attitudes towards obstetrical technology using an analytical framework that includes literature on the philosophy of technology, as well as the sociology of childbirth. Data were gathered using a survey instrument and semi-structured interviews to contrast women's attitudes towards technology and experiences of childbirth in a large Canadian city: 25 women who planned a home birth assisted by a midwife and 25 low-risk women who planned a hospital birth. The results reveal that the total number of interventions the women experienced correlates in part to their attitudes towards technology: resistance to it on the part of home birthers and flexibility on the part of hospital birthers. Home birthers' resistance to technology stemmed from a consciousness of its overuse which blocks awareness of a sacred and authoritative "birthing force". Rather than rejecting technology, however, home birthers made conscious decisions about its appropriate use and relied upon access to a range of secondary technologies.

Attitude↗
PubMed2001

The effect of technology on the caring attributes of an international sample of nurses.

This paper commences by refining the psychometric characteristics of a quantitative instrument, which was developed to examine the caring attributes of an international sample of 1957 nurses working in 11 countries. Using factor analysis to support the construct validity, and removing weak items, the original 60 caring items were reduced to a 31 item global caring scale which revealed the sub-scales: 'caring communication'; 'caring involvement'; 'caring advocacy'; and 'learning to care'. The sub-scales were internally consistent and revealed generally high correlation coefficients. The subjects also responded to a scale, which was designed to measure degree of technological influence and provide a score for each respondent to reflect how highly they were influenced by technology in the work units of their hospital. The sample was then divided into three equal groups to reflect high, medium and low technological influence. The caring attribute scores then became the dependent variable by which the degree of technology was compared. The group with the lowest technological influence recorded the lowest mean score for caring while the group with the highest technological influence recorded the highest mean score for caring. A significant difference between the group with lowest and highest technological influence (F=6.84, p<0.001) was noted. This also applied to the 'caring communication' and 'caring involvement' sub-scales. For 'caring advocacy' the lowest technology group recorded the highest caring mean which was found to be significantly different to both mean scores for medium and highest technology groups (F=7.15, p<0.001). These results are discussed in the light of the international sample and suggestions for future research are raised.

Attitude of Health Personnel↗
PubMed1993

A model for integrating technology into a multi-agency community service delivery system.

This article presents the results of a 4-year project to develop and test a model for integrating technology into a multi-agency community human services delivery system. "Technology" in this sense refers to both information technology and assistive technology. The project focused on systems change rather than on the creation of comprehensive assistive technology services. Several strategies of the model were developed and tested by the project. The project developed an information/communication tier that lay on top of the existing service delivery system. The information/communication tier was provided to agencies through an electronic network and searchable database, assistive technology advice-giving software, a public awareness campaign, and professional training. The results of these strategies are used to illustrate the Community Assistive Technology Services Network (CATSN) model. The model consists of five modules: 1) client assessment and technology examination, 2) professional and client training and technical assistance, 3) information and referral and needs analysis, 4) special projects, and 5) central coordination and facilitation--the hub. This model is important given recent nationwide initiatives for using assistive technology to provide people with disabilities opportunities for maximum independence, productivity, and integration.

Community Health Services↗
PubMed2006

The application of microarray technology to neuropathology: cutting edge tool with clinical diagnostics potential or too much information?

Microarray technology is a tremendously powerful method for simultaneously monitoring the expression of thousands of species of nucleic acids, usually cellular mRNA, producing a high-resolution representation of the genes encoded or expressed in a cell. As such, microarray technology has great potential for impacting research and clinical approaches to treatment. However, this complex technology has been challenging to apply as a result of difficulties discerning biologic variation from technologic issues, therefore slowing the application of the technology to human diagnostics. Nevertheless, significant advances in microarray technology, improvements that avoid potential pitfalls, and a wider spectrum of application are making this technology easier to apply. Indeed, microarray technology has provided valuable insights into mechanisms involving gene regulation and expression in Alzheimer disease, and it remains a powerful tool to identify biomarkers for disease diagnosis. Ultimately, the most robust markers will enable the application of more specific treatments particular to disease stages or subcategories. Currently, no widely applicable molecular test is available to identify those at risk for developing Alzheimer disease or those who have early markers of pathology but show discernible cognitive impairment. The progression of this technology will lead to earlier detection of the disease through enhanced understanding of disease onset and progression.

Alzheimer Disease↗
PubMed2003

The practice of medical technology.

In this article, we review 25 years of sociological scholarship published in Sociology of Health and Illness on medical technologies. We divide the literature into three theoretical perspectives: technological determinism views medical technology as a political force to shape social relationships, social essentialism emphasizes how medical technologies are neutral tools to be interpreted in social interactions, and technology-in-practice highlights the dialectic relationship between technology and its users in health care. While the technology-in-practice orientation allows social scientists to critique the high hopes and dire warnings embedded in medical technologies, we argue that the logical next step of this paradigm is to move beyond criticism and influence the creation and implementation of medical technologies.

Bibliometrics↗
PubMed2004

Major psychological factors affecting acceptance of gene-recombination technology.

The purpose of this study was to verify the validity of a causal model that was made to predict the acceptance of gene-recombination technology. A structural equation model was used as a causal model. First of all, based on preceding studies, the factors of perceived risk, perceived benefit, and trust were set up as important psychological factors determining acceptance of gene-recombination technology in the structural equation model. An additional factor, "sense of bioethics," which I consider to be important for acceptance of biotechnology, was added to the model. Based on previous studies, trust was set up to have an indirect influence on the acceptance of gene-recombination technology through perceived risk and perceived benefit in the model. Participants were 231 undergraduate students in Japan who answered a questionnaire with a 5-point bipolar scale. The results indicated that the proposed model fits the data well, and showed that acceptance of gene-recombination technology is explained largely by four factors, that is, perceived risk, perceived benefit, trust, and sense of bioethics, whether the technology is applied to plants, animals, or human beings. However, the relative importance of the four factors was found to vary depending on whether the gene-recombination technology was applied to plants, animals, or human beings. Specifically, the factor of sense of bioethics is the most important factor in acceptance of plant gene-recombination technology and animal gene-recombination technology, and the factors of trust and perceived risk are the most important factors in acceptance of human being gene-recombination technology.

Adolescent↗
PubMed1994

Professional uncertainty: nurses in the technologically intense arena.

The implementation of medical technology in health care continues to escalate. Using a grounded theory methodological approach, nurses were interviewed regarding their feelings about medical technology and its impact on their practice. Through the medium of participant observation nurses were observed as they worked in a technologically intense general hospital in the United States. Nurses were ambivalent regarding the benefits of medical technology to nursing practice and patient care. In particular, they questioned whether the use of techniques facilitated relationships with patients or detracted from them. Findings showed that, in the practice setting, it appeared that most of the nurses' time was spent in co-ordinating, assessing and manipulating equipment. Technology structured nurses' time and gave their role some parameters. Technology also shaped the nurse-patient relationship and limited interactions to educational instruction, physical assessments and strategies to support the technology. Nurses' ambivalence regarding the benefits of technology appeared to be symptomatic of professional uncertainty. The hospital focus on technology is contrary to the considerable appreciation of the psychosocial nurse-patient relationship with which the neophyte nurse has been imbued. This practice-educational dichotomy causes role uncertainty for the registered nurse.

Attitude of Health Personnel↗
PubMed2006

Racial differences in attitudes toward innovative medical technology.

BACKGROUND: New medical technologies are used at different rates among whites and blacks. This variation may be partially explained by racial differences in patient innovativeness-the propensity of patients to adopt unfamiliar therapies. OBJECTIVE: To measure how innovativeness varies among patients and how it may influence patients' attitudes toward new medical technologies. DESIGN: Cross-sectional survey. PARTICIPANTS: Primary care patients (n=171-108 blacks, 63 whites) at an urban Veterans Affairs medical center. MEASUREMENTS: Respondents answered questions about their general innovativeness and innovativeness regarding medical technology, and they responded to a vignette describing either a hypothetical new prescription drug or implantable device. RESULTS: There were no significant racial differences in general innovativeness, but whites had higher medical technology innovativeness (P=.001). Whites were also more likely to accept the new prescription drug (P=.003), but did not differ from blacks in acceptance of the new implantable device. In multivariate analyses, lower medical technology innovativeness scores among blacks were significantly associated with less favorable reactions to both the prescription drug (P<.001) and the medical device (P<.001). In contrast, although whites with lower medical technology innovativeness were similarly less inclined to accept the new implantable device (P=.02), there was no significant association between medical technology innovativeness and positive attitudes to the new prescription drug among whites. CONCLUSIONS: Blacks and whites have differing attitudes toward medical innovation. These differences are associated with significant racial differences in response to particular health care technologies. These findings suggest potentially remediable causes for racial differences in the utilization of innovative medical technologies.

Attitude to Health↗
PubMed2005

Technology for enhanced transfusion safety.

Data from reporting systems around the world document that non-infectious hazards are the leading cause of serious morbidity or mortality resulting from blood transfusion. Among these non-infectious hazards, mis-transfusion represents the most frequently observed serious hazard and occurs at an estimated rate of 1 in 14,000 transfusions. Mis-transfusion events result from "lapse errors" (slip ups) rather than cognitive mistakes. Lapse errors are more likely to occur during repetitive tasks when individuals are distracted, rushed, or fatigued--conditions to which machines are not susceptible. The final bedside check and the collection of patient samples for pre-transfusion testing are key "error spots" and are candidates for new technology innovation. Existing technology includes non-computerized devices; bedside devices based on bar code technology; and the use of radiofrequency chips. Several commercial systems employing bar-code technology have reached clinical application or are undergoing refinement. Radiofrequency-based systems are on the near horizon. Nearly all systems begin with the application of machine-readable data to the patient's wristband. The third error spot--the decision to transfuse--will be a challenging area for future application of information technology. Computerized physician order-entry, decision support and ultimately active computer-based decision-making are expected to enhance transfusion decisions. Despite the explosive growth in information technology in modern society, healthcare has lagged behind many other sectors in the use of enhanced information technology. Studies are needed to identify which technologies improve patient outcomes. Healthcare workers, administrators, and regulators need to embrace the use of new technology in order to reduce errors and improve safety for patients.

Blood Transfusion↗