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PubMed2006

Factors that influence the use of assistance technologies by older adults who have a hearing loss.

The objective of this study was to describe and better understand the factors that influence the use of assistance technologies by older adults who have a hearing loss. We were interested in adopting a methodological approach that would provide an in-depth account of individual experiences related to the use of these technologies. A qualitative research design was therefore selected. Audio-recorded interviews were conducted with ten individuals who were 65 years of age or older and were current successful assistance technology users. Thematic analysis was used to draw meaning from the interview transcripts. The results suggest that successful use of these assistance technologies involves the recognition of hearing difficulties, an awareness that technological solutions exist, consultation for and acquisition of devices, and adapting to device use and modified behaviour. These four landmarks seem to be crucial stages when people either move toward successful assistance technology use or are discouraged from assistance technology use. Based on these results, a representative model of assistance technology awareness, acquisition and utilization is proposed.

Activities of Daily Living↗

PubMed2003

Making the right connection: matching patients to technology.

Although technology has sometimes been the cause of rising healthcare costs, telemedicine technology has been proposed as a means to increase productivity in the workplace and reduce resource utilization for high-risk populations. The Veterans Health Administration (VHA) in April of 2000, implemented an expansive telemedicine technology initiative in its Sunshine Network, covering veterans in south Georgia, Florida, Puerto Rico, and the Virgin Islands through the Community Care Coordination Service (CCCS). The initiative uses home telehealth technology to support veteran healthcare. Choosing appropriate tools to enhance care coordination and matching technology to specific patient needs was vital to the success of the CCCS model. A technology algorithm was developed across the Network initiative and grew out of a need to identify and benchmark best practices. An evaluation methodology developed by a health economist and his research team at the University of Maryland was used to determine patient satisfaction with technology and functional status through a validated instrument. Outcomes were for 791 chronic medical and 120 mental health patients. Patient satisfaction was extremely high, patients used technology without difficulty and acceptance was greater than expected. Patients' perception of health as surveyed with the functional status instrument showed improved perception in many factors including pain, physical, and social functioning.

Algorithms↗

PubMed2004

Incidence of spontaneous abortion among pregnancies produced by assisted reproductive technology.

BACKGROUND: There has been increasing number of pregnancies following assisted reproductive technology treatment and their survival is understandably a matter of interest. The relative risk of spontaneous abortion in these pregnancies remains unclear. The objectives of this study were to quantify the relative risk in assisted reproductive technology pregnancies in relation to two cohorts of naturally conceived pregnancies and to assess the possible risk factors for spontaneous abortion among assisted reproductive technology pregnancies. METHODS: Three cohorts of pregnancies, 1945 pregnancies conceived following assisted reproductive technology treatment in a tertiary infertility clinic, 549 natural pregnancies in a prospective study of lifestyle and pregnancy (the Ford cohort), and 4265 pregnancies from another cohort (the Treloar cohort), were used in the study. RESULTS: After adjusting for age, the relative risk of spontaneous abortion was 1.20 (95% CI 1.03-1.46) in the assisted reproductive technology cohort in comparison with the Ford cohort. Within the assisted reproductive technology cohort, a history of spontaneous abortion predicted increased risk, while a low level of ovarian stimulation seemed to be related to a reduced risk. CONCLUSIONS: The study showed that the risk of spontaneous abortion was slightly increased in the assisted reproductive technology pregnancies after adjusting for maternal age and previous spontaneous abortion. Within the assisted reproductive technology cohort, several variables, including the level of stimulation, appeared to be linked with the risk of spontaneous abortion.

Abortion, Spontaneous↗

PubMed2001

Frequency doubling technology and confocal scanning ophthalmoscopic optic disc analysis in open-angle glaucoma with hemifield defects.

PURPOSE: To evaluate the potential of frequency doubling technology for detecting early glaucomatous damage. PATIENTS AND METHODS: Forty-nine eyes of 49 patients with open-angle glaucoma with visual field defects only in one hemifield according to the Humphrey Field Analyzer 30-2 program were included. Forty-five healthy patients were also included as control subjects. In each patient, frequency doubling technology with the threshold N-30 program and optic disc analysis using the Heidelberg Retina Tomograph was performed. Frequency doubling technology test results and the Humphrey Field Analyzer test results were compared. Optic disc parameters corresponding to the hemifield designated intact by the Humphrey Field Analyzer were compared between the eyes in which the hemifield was normal by frequency doubling technology and those in which the hemifield was abnormal. RESULTS: Forty-one percent of the 49 hemifields designated intact by the Humphrey Field Analyzer were abnormal based on frequency doubling technology, whereas 98% of the 49 hemifields designated defective by the Humphrey Field Analyzer were abnormal and 12% of the 90 hemifields designated intact by the Humphrey Field Analyzer were abnormal in healthy patients. The percentage of the hemifields designated abnormal by frequency doubling technology was significantly higher than that in healthy patients (P < 0.001). The rim volume was significantly smaller in eyes with abnormal results based on frequency doubling technology than in eyes with normal results (P < 0.05, paired t test, with Bonferroni correction for multiple comparison). CONCLUSION: Frequency doubling technology can detect glaucomatous damage earlier than conventional static perimetry can.

False Positive Reactions↗

PubMed2003

Staging of functional damage in glaucoma using frequency doubling technology.

PURPOSE: To evaluate three new approaches for staging severity of glaucomatous visual field defects using frequency doubling technology. PATIENTS AND METHODS: One hundred and four patients with either ocular hypertension or chronic glaucoma were tested with both standard automated perimetry (SAP, 30-2 Humphrey threshold test) and frequency doubling technology (N-30 threshold test). Standard automated perimetry results were classified into four groups (normal tests, early defects, moderate defects, and severe defects) using the Glaucoma Staging System. Frequency doubling technology tests were also classified in four groups using three different approaches: frequency doubling technology probability map analysis, considering the number and location of disturbed points, frequency doubling technology MD and PSD indices, graphed on a two-axis diagram (FDT Staging System), and an abnormality score, based on both the statistical significance and the spatial location of depressed points. A control group of 20 eyes from 20 normal subjects was also tested and classified in the same way. The Cohen Kappa was used to compare the level of agreement between the three frequency doubling technology methods of classification and the glaucoma staging system. RESULTS: Measure of agreement was 0.679 using probability map assessment, 0.793 using the frequency doubling technology staging system, and 0.663 using the abnormality score. The specificity rate was 95% for all three methods. CONCLUSIONS: All the studied approaches were able to correctly stage the glaucomatous functional damage, but the frequency doubling technology staging system was the easiest and quickest method. Moreover, it is the only method that supplies information on the characteristics of the defect, without requiring any other time-consuming procedures.

Chronic Disease↗

PubMedDate not supplied

Using information technology to improve the public health system.

Information technology can be both a vital tool and critical link in the modern public health system. This article discusses the role of information technology in public health and the activities of the Information Technology Collaborative, one of the collaboratives that comprise the national Turning Point initiative. Data are presented from a nationwide survey investigating local health department information technology needs and information technology use. This data, and data from an investigation of state-level public health information technology, will be presented in a more complete format on the Information Technology Collaborative's online Public Health Information Systems Catalog, a free resource for individuals interested in public health informatics. Recommendations for future initiatives, policy changes, and information technology standards are discussed.

Catalogs as Topic↗

PubMed1999

Applied studies of plant meridian system: I. The effect of agri-wave technology on yield and quality of tomato.

Agri-wave technology is a new agricultural technology based on the plant meridian system, that focuses on measurement of plant sound characteristics. The basic principle of agri-wave technology is to improve the yield and quality of plants such as vegetables, flowers, and fruit trees by broadcasting sound waves of certain frequencies and spraying a compound microelement fertilizer on the leaves. The application of agri-wave technology on tomatoes remarkably stimulates growth of their seedlings. Fresh weight of the branch, stems, and leaves of the treated tomatoes is significantly (59.53%, P < 0.0001) higher than that of the control group. Sampling survey results indicate that agri-wave technology accelerates the ripeness of tomatoes. The fresh weight of ripe tomatoes treated with this technique is 30.73% higher than that of the untreated (P = 0.0018), while the fresh weight of the treated unripe tomatoes is 27.29% lower than that of the untreated unripe group (P = 0.0020). Yield surveys show that the yield of treated plants is 13.89% (p < 0.0001) higher than that of the control group. Moreover, with agri-wave technology treatment the storage period of tomatoes is almost doubled. Analysis of tomato nutrition shows that agri-wave technology has increased their sugar content by 26.19%, vitamin A and niacin (an antifavours vitamin) by 55.39% and 92.31% respectively. There is no difference concerning vitamin B1, B2, and D content between the two groups, and vitamin C and E contents decreased by 2.10% and 12.69%, respectively. Among the analyzed 33 minerals of tomatoes, 26 increased in content, while 7 decreased. In conclusion, agri-wave technology has promoted the growth of the tomato, increased its yield, and improved its quality.

Agriculture↗

PubMedDate not supplied

Reflections on ethics, technology, and learning disabilities: avoiding the consequences of ill-considered action.

Over the last several years, the field of learning disabilities has directed considerable attention toward the area of technology. However, there have been few discussions regarding the larger ethical implications that surround the use of technology with persons with learning disabilities. This article employs the fundamental ethical principles of beneficence, justice, and autonomy as a framework from which to reflect upon the use of technology with persons with learning disabilities to help ensure that the greatest possible rewards will be gained, while simultaneously minimizing any potential negative consequences. These principles are applied to a number of topics, including instructional/remedial, assistive, and diagnostic technology; technology and special abilities; social/psychological impact of technology; health-related concerns; technological access; and medical technologies.

Education, Special↗

PubMed2005

Emerging technologies for cancer prevention and other population health challenges.

Emerging technologies, such as information and communication technologies (including future versions of the Internet), microelectromechanical systems, nanotechnologies, genomics, robotics, artificial intelligence, and sensors, provide enormous opportunities for enhancing health and quality of life. Population health technologies (PHTs) encompass the various applications of emerging technologies to improve the health of populations and communities. These technologies may change many population health paradigms, including those related to cancer prevention and control. In the future, emerging technologies will allow true customization of health communication to individuals, and existing tailoring approaches will be considered very crude. Environmental monitoring systems based on emerging technologies could also provide real-time information that health officials and community residents could use immediately to ameliorate potential carcinogenic or unhealthy exposures. Accelerating the application and diffusion of emerging technologies to population health challenges will require a multipronged approach, including new transdisciplinary programs, increased funding, supportive infrastructure, and policy changes.

Communication↗

PubMedDate not supplied

Information technology and cancer prevention.

Information technology is rapidly advancing and making its way into many primary care settings. The technology may provide the means to increase the delivery of cancer preventive services. The aim of this systematic review is to examine the literature on information technology impacts on the delivery of cancer preventive services in primary care offices. Thirty studies met our selection criteria. Technology interventions studied to date have been limited to some type of reminder to either patients or providers. Patient reminders have been mailed before appointments, mailed unrelated to an appointment, mailed after a missed appointment, or given at the time of an appointment. Telephone call interventions have not used technology to automate the calls. Provider interventions have been primarily computer-generated reminders at the time of an appointment. However, there has been limited use of computer-generated audits, feedback, or report cards. The effectiveness of information technology on increasing cancer screening was modest at best. The full potential of information technology to unload the provider-patient face-to-face encounter has not been examined. There is critical need to study these new technologic approaches to understand the impact and acceptance by providers and patients.

Humans↗

PubMed1986

The impact of public opinion on medical technology: the case of artificial heart implants.

A public opinion survey was conducted in the spring of 1985 in Kentucky to assess public attitudes toward artificial heart technology. The data, based on consumer and citizen perspectives, indicate that the public is interested in and aware of the technology and recent implant surgeries. More knowledgeable respondents are more likely to support Humana's involvement, but less likely to want an artificial heart and other organs to continue life, and less willing to support equitable access and increased taxes to achieve this equity. Technological optimists are more willing to have the heart and other organs as needed and more willing to have their taxes increased to pay for the technology for all in need. Optimists also see nothing wrong with Humana's involvement in this technology. People's judgments on artificial heart technology vary, depending on whether they see it as potentially desirable for themselves as opposed to possible implications for others and the broader society. Although both perspectives are crucial for understanding the role of public opinion on the further development of this technology, it must be recognized that the two perspectives might have different impacts, depending on societal judgment of whether the decision to proceed with further development of the technology is mostly a public or private choice.

Attitude to Health↗

PubMed1999

Life support in the intensive care unit: a qualitative investigation of technological purposes. Canadian Critical Care Trials Group.

BACKGROUND: The ability of many intensive care unit (ICU) technologies to prolong life has led to an outcomes-oriented approach to technology assessment, focusing on morbidity and mortality as clinically important end points. With advanced life support, however, the therapeutic goals sometimes shift from extending life to allowing life to end. The objective of this study was to understand the purposes for which advanced life support is withheld, provided, continued or withdrawn in the ICU. METHODS: In a 15-bed ICU in a university-affiliated hospital, the authors observed 25 rounds and 11 family meetings in which withdrawal or withholding of advanced life support was addressed. Semi-structured interviews were conducted with 7 intensivists, 5 consultants, 9 ICU nurses, the ICU nutritionist, the hospital ethicist and 3 pastoral services representatives, to discuss patients about whom life support decisions were made and to discuss life-support practices in general. Interview transcripts and field notes were analysed inductively to identify and corroborate emerging themes; data were coded following modified grounded theory techniques. Triangulation methods included corroboration among multiple sources of data, multidisciplinary team consensus, sharing of results with participants and theory triangulation. RESULTS: Although life-support technologies are traditionally deployed to treat morbidity and delay mortality in ICU patients, they are also used to orchestrate dying. Advanced life support can be withheld or withdrawn to help determine prognosis. The tempo of withdrawal influences the method and timing of death. Decisions to withhold, provide, continue or withdraw life support are socially negotiated to synchronize understanding and expectations among family members and clinicians. In discussions, one discrete life support technology is sometimes used as an archetype for the more general concept of technology. At other times, life-support technologies are discussed collectively to clarify the pursuit of appropriate goals of care. CONCLUSIONS: The orchestration of death involves process-oriented as well as outcome-oriented uses of technology. These uses should be considered in the assessment of life-support technologies and directives for their appropriate use in the ICU.

Attitude of Health Personnel↗

PubMed2000

Next-generation pulse oximetry. Focusing on Masimo's signal extraction technology.

Pulse oximeters are used to determine trends in patients' blood oxygen saturation and to warn of dangerous saturation levels. But conventional pulse oximetry has some inherent limitations. For example, it has difficulty monitoring patients who are moving or who have poor perfusion; it is also subject to interference from certain visible and infrared light sources. Over the past several years, a number of companies have developed advanced signal-processing techniques that allow pulse oximeters to overcome many of these limitations. We refer to such new technologies as next-generation pulse oximetry. In this Evaluation, we focus on the first next-generation technology to have reached the market: Masimo Corporation's Signal Extraction Technology (SET). We designed our study of Masimo SET to address the main question that needs to be asked of any next-generation technology: How well does it compare to conventional pulse oximetry? Specifically, how well does it perform when a patient is moving or being moved, when a patient is poorly perfused, or when certain types of light strike the sensor while it is attached to or detached from the patient? We also examined one type of sensor used with this product, comparing it to conventional tape-on sensors for comfort and durability. Several other next-generation pulse-oximeter products have become available since we began this study. We are currently evaluating these products and will publish our findings in the near future. A list of the products, including a brief description of each, is included in this article. Pulse oximeters are used to determine trends in patients' blood oxygen saturation and to warn against dangerous saturation levels. These monitors are often vital in helping to ensure patient safety, especially for critically ill patients, pediatric patients, and neonates. But conventional pulse oximetry has some inherent limitations--most significantly, it has difficulty monitoring patients who are moving or who have poor perfusion. Although gradual improvements have been made to the technology, only recently has it advanced to the point where it has really begun to overcome these limitations. A number of manufacturers have developed advanced signal-processing algorithms that allow pulse oximeters to "read through" motion and conditions of poor perfusion. The first of these "next-generation" pulse-oximeter technologies that reached the market was Masimo Corporation's Signal Extraction Technology (SET). We tested that product in this Evaluation. In this Overview, we'll tell you about conventional pulse oximetry and its shortfalls, next-generation technology and how it's designed to improve on the old methods, and how we approached our Evaluation of Masimo SET.

Adult↗

PubMedDate not supplied

Modern information technologies in environmental health surveillance. An overview and analysis.

In recent years we have witnessed the massive introduction of new information technologies that are drastically changing the face of our society. These technologies are being implemented en masse in developed countries, but also in some pockets of developing nations as well. They rely on the convergence of several technologies such as powerful and affordable computers, real-time electronic measurement and monitoring devices, massive production of digital information in different formats, and faster, wireless communication media. Such technologies are having significant impacts on every domain of application, including environmental health surveillance. The current paper provides an overview of those technologies that are having or will likely have the most significant impacts on environmental health. They include World Wide Web-based systems and applications, Database Management Systems and Universal Servers, and GIS and related technologies. The usefulness of these technologies as well as the desire to use them further in the future in the context of environmental health are discussed. Expanding the development and use of these technologies to obtain support for global environmental health will require major efforts in the areas of data access, training and support.

Decision Support Systems, Management↗

PubMed2002

The socio-legal acceptance of new technologies: a close look at artificial insemination.

Heated debates often surround the introduction of an important new technology into society, as exemplified by current controversies surrounding human cloning and privacy protection on the Internet. Underlying these controversies are disruptions to central socio-legal values caused by these new technologies. Whether new technologies will eventually be accepted by society is often contingent on the reaction of the legal system. This mandates the formulation of a conceptual framework for understanding and structuring the way the law should react in cases surrounding the adoption of new technologies. By using the case study of artificial insemination this Article develops the tools for structuring the legal role in the acceptance process of new technologies. The three-century controversy surrounding the innovation of artificial insemination results from the innovations' disruption of the socio-legal value of the family. Artificial Insemination--although invented in the eighteenth-century--was rarely used until the 1930s, and only legalized in the 1960s. Its application to surrogacy and its use by unmarried women extends the controversy into the twenty-first century. The case study demonstrates the nature of the relationship among the technological, social and legal acceptance processes of new technologies, and analyzes the legal acceptance debate. The conceptual framework produced is useful in understanding and structuring the legal role in current debates surrounding the introduction and acceptance of new technologies.

Attitude↗

PubMed1995

The role of obstetrical medical technology in preventing low birth weight.

Technology plays an important role in the practice of medicine, and it is essential that controlled clinical trials be conducted before new technologies are widely disseminated. In this article, information from the medical literature is summarized and critiqued for several common obstetric technologies which are aimed at reducing the incidence or sequelae of low birth weight and preterm birth. These technologies include home uterine activity monitoring, tocolytic drugs to suppress uterine contractions, corticosteriods to accelerate fetal lung maturity, bed rest to prevent preterm delivery, delivery methods, multifetal pregnancy reduction, and cervical cerclage. A major challenge to the practice of medicine is to find effective ways to modify physician behavior to encourage the use of proven, effective technologies, and discourage the use of unproven, ineffective technologies. Despite widespread use, most obstetrical technologies appear to have had little impact on reducing the incidence of low birth weight or preterm births, as rates of low birth weight and preterm birth have not decreased appreciably in the past 25 years. Uncovering the basic mechanisms responsible for the onset of preterm labor will undoubtedly facilitate the discovery of new technologies to prevent low birth weight and preterm births.

Female↗

PubMed2000

Role of ergonomics in the transfer of technology to industrially developing countries.

Technological development has contributed to economic growth and social progress as well as a reduction of many sources of occupational accidents, injuries and stresses. However, advanced technology has also brought new sources of work stress and injuries. Industrially developing countries (IDC) have tended to try to achieve economic growth and development by importing technology designed for IDC. However, because of several complex technical, cultural and socio-economic factors, this policy has not been always successful. Inappropriate technology transfer has led to many work environment and productivity problems. Consideration of ergonomics in the choice and utilization of the transferred technology can help to create a good fit between technology, technology users and the operating environment. Application of ergonomics is, however, not widely spread in most IDC. Ergonomics input will create the appropriate working environment in which people are safe and motivated to participate and can better utilize company resources for increasing system productivity, reliability and availability.

Developing Countries↗

PubMedDate not supplied

Transporting values by technology transfer.

The introduction of new medical technologies into a developing country is usually greeted with enthusiasm as the possible benefits become an object of great anticipation and provide new hope for therapy or relief. The prompt utilization of new discoveries and inventions by a medical practitioner serves as a positive indicator of high standing in the professional community. But the transfer of medical technology also involves a transfer of concomitant values. There is a danger that, in the process of adopting a particular technology, the user takes for granted the general utility and desirability of the implements and procedures under consideration without recognizing the socio-cultural peculiarities of the adopting country. A sensitivity to the social conditions and cultural traditions is important so that the emergence of new values can be examined critically and the transfer of necessary technology can be effected smoothly. In the Philippines, efforts to boost patronage of transplant technology appear to have overlooked this need for socio-cultural sensitivity. Legislative fiat cannot be used to override deep-seated values. There is a need to be more sensitive to the possible confrontation of values that the transfer of technology brings in order to avoid the erosion of indigenous socio-cultural values and minimize the intrusiveness of beneficial medical technology.

Altruism↗