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Technology and nursing education: a scenario for 1990.

An examination of predictions concerning the future of American society provides a basis for building a scenario for nursing education in the USA. Trends influencing the future of society and professional nursing education include the tendency towards a planet-wide society, changing orientations towards individual towns and cities, changes in the occupational structure and in use of energy, and technological breakthroughs in electronics and genetics. Central to new technologies is the computer. Computerized systems of education and networks of such systems are now technically possible. Although capital resources for such systems may be scarce, eventually the substitution of capital for the even more expensive human labour may force the use of greater technology in education. Teacher acceptance is the greatest challenge to increased use of technology in education. Teacher acceptance is the greatest challenge to increased use of technology in education. Increased use of technology may force better instruction. Increased technology does not presuppose a less humanistic education.

Education, Nursing↗

Using technology to reduce maternal mortality in low-resource settings: challenges and opportunities.

Technology--consisting of equipment, supplies, procedures, and techniques--can play a central role in the management of pregnancy-related complications. Implementing proven interventions in developing countries and low-resource settings has been difficult, however, because skilled human and financial resources are constrained, and the physical and epidemiological environments are challenging. This article examines the limitations and challenges affecting health technologies in low-resource settings and suggests a framework for characterizing specific technology-based solutions. It also provides examples of pregnancy-related problems in which the introduction of new or modified technologies (drugs for prevention and management of postpartum hemorrhage, infection treatment, manual vacuum aspiration, preeclampsia detection and eclampsia management, partograms, and vacuum extraction) could help save women's lives. The authors call for a more complete assessment of the technology needs associated with pregnancy-related problems in low-resource settings, including evaluating alternative technology-based possibilities, carefully synthesizing and disseminating existing information, and characterizing the nature of current challenges. When accompanied by appropriate provider knowledge and skills, practice guidelines, financing and distribution systems, and community support, technology-based solutions can contribute to a significant reduction in maternal morbidity and mortality around the world.

Developing Countries↗

Health care technology assessment. Basic principles and clinical applications.

Health care technology (defined as all drugs, devices, and medical and surgical procedures used in medical care as well as the organizational and supportive systems within which such care is provided) is widely regarded as an important driver of escalating health care spending in the United States. Many new health care technologies are adopted and used in clinical practice with little or no evidence that their use is associated with improved patient outcomes. Orthopaedic surgeons are facing increasing scrutiny from hospitals and payers regarding the adoption and use of new technology for the treatment of patients with musculoskeletal disease. Health care technology assessment is a growing field that is concerned with the multidisciplinary evaluation of clinical data on the basis of safety and efficacy as well as economic aspects of technology acquisition. Through an understanding of the relevant literature and the concepts of health care technology assessment, orthopaedic surgeons have an opportunity to participate in the assessment process and thus influence clinical and health policy decisions regarding the adoption and use of new and existing technologies in the field of orthopaedic surgery.

Delivery of Health Care↗

Medical technology management: bridging the gap between theory and practice.

New medical technologies that offer to improve upon or completely replace existing ones are continuously appearing. These technologies are forcing healthcare policymakers to consistently evaluate new treatment options. However, emerging medical technology has been viewed as a significant factor in increasing the cost of healthcare. The abundance of new medical alternatives, combined with scarcity of resources, has led to priority setting, rationing, and the need for further technology management and assessment. Economic evaluation of medical technologies is a system of analysis within the framework of health technology assessment to formally compare the costs and consequences of alternative healthcare interventions. EEMT can be used by many healthcare entities, including national policymakers, manufacturers, payers and providers, as a tool to aid in resource allocation decisions. In this paper we discuss the historical evolution and potential of EEMT, the practical limitations hindering more extensive implementation of these types of studies, current efforts at improvement, and the ethical issues influencing ongoing development. The Medical Technologies Administration in Israel's Ministry of Health is given as an example of an entity that has succeeded in practically implementing EEMT to optimize healthcare resource allocation.

Biomedical Technology↗

Decisions to adopt new technologies at the hospital level: insights from Israeli medical centers.

OBJECTIVES: New medical technologies have been identified as the leading cause of increasing health-care expenditures. Adoption of a new technology is one of the most important decisions in medical centers. The objectives of this study were to map and describe the function of hospital decision-makers within the area of new technology assessment and adoption, and to examine relevant considerations, sources of information, and decision-making processes in the adoption of a new technology. METHODS: A questionnaire was mailed to hospital executives and referred to (i) the considerations for and against adoption of a new technology, (ii) the decision-making process, (iii) information sources used in the decision-making process. RESULTS: The most frequent criteria favoring adoption included increased cost-effectiveness, increased efficacy, and decrease in complication rates. An increase in complication rates or side effects and decreased efficacy were the top ranked criteria against adoption. The final decision-making responsibility varied among technologies; the medical director frequently made the final decision when a new device was involved, but this responsibility decreased when a new drug or a new procedure was considered, Participation in scientific meetings, opinions of local experts, medical journals, and Food and Drug Administration clearance documents were the most important information sources used in the decision-making process. However, these were not necessarily the optimal sources of information. Significant barriers in adoption decision-making are lack of timely data regarding the safety of the new technology, its cost-effectiveness, and efficacy. CONCLUSION: To improve the adoption decisions, hospitals must develop criteria upon which the decision-making will be based.

Biomedical Technology↗

The prospects for medical technology in the next decade.

Powerful forces encourage the growth of medical technology (health benefits, private equity capital, public funding, pervasive academic research, consumer demand, specialist training, reimbursement mechanisms, and industry competition). Countervailing forces that inhibit growth are the costs of the technology, difficulty in evaluating clinical and cost effectiveness, unequal patient access, and misuse, overuse, and underuse. While technology funding sources continue to expand, so do the methodologies for technology assessment. They are part of a broad movement to better manage the diffusion of medical technology. Specific proposals include more centralized planning, more discriminating federal funding, drug price controls, curtailing insurance reimbursements, more selective adoption of new technologies, and more rigorous attention to cost effectiveness. Savvy develops of and investors in new medical technology will anticipate these changes and take them into account in their planning.

Biomedical Research↗

Medical high-technology assessment and implementation in a community hospital: nuclear magnetic resonance.

Health care administrators and physicians are under intense pressure from the government, industry, and the public at large to contain the escalating cost of health care. Operating margins of hospitals are averaging about 1%, and some hospitals are closing their doors. Health care providers are thus faced with the dilemma of how to bring costly high technology to a community hospital in a timely and effective manner without incurring serious financial setbacks. Despite all these pressures, we have presented several reasons why a community hospital should bring costly technology to its medical staff, and thus to its patients. We have described Kettering Medical Center's approach to this problem and our success in bringing it to the community early and cost-effectively, which has benefited the local community as well as the medical center. Our desire to be one of the "early adopters" may not work for everyone, since it requires extremely careful and perceptive evaluation of the technologic developments. It requires an intelligent, progressive, and committed board, administration, and medical staff, and it requires clever financing, such as large outside grants and help from a medical school. Such partnerships and research organizations, or liaisons with government agencies such as the Veterans Affairs system, are believed to be the keys in getting costly high technology into a community hospital. To achieve this, administration and key medical staff should constantly be on the lookout, evaluating high-technology developments. Once the hospital decides to get into a costly new high technology, it must seek alliances or partnerships with others. To identify, assess, and acquire new technology is an ongoing process.(ABSTRACT TRUNCATED AT 250 WORDS)

Cost Control↗

How can information technology improve patient safety and reduce medication errors in children's health care?

BACKGROUND: Medication errors are common, costly, and injurious to patients. OBJECTIVE: To review the role of information technology in decreasing pediatric medication errors in both inpatient and outpatient settings. DESIGN: We performed a literature review of current information technology interventions. RESULTS: Several types of information technology will likely reduce the frequency of medication errors, although insufficient data exists for many technologies, and most available data come from adult settings. Computerized physician order entry with decision support substantially decreases the frequency of serious inpatient medication errors in adults. Certain other inpatient information technologies may be beneficial even though less evidence is currently available. These include computerized medication administration records, robots, automated pharmacy systems, bar coding, "smart" intravenous devices, and computerized discharge prescriptions and instructions. In the outpatient setting, where adherence is especially important, personalized Web pages and World Wide Web-based information have substantial potential. CONCLUSIONS: Medication errors are an important problem in pediatrics. Information technology interventions have great potential for reducing the frequency of errors. The magnitude of benefits may be even greater in pediatrics than in adult medicine because of the need for weight-based dosing. Further development, application, evaluation, and dissemination of pediatric-specific information technology interventions are essential.

Adolescent↗

Food technology: challenge for health promotion.

The food technology has brought countless benefits to today's food supply. Despite its many positive contributions, it has also brought unintended negative consequences. It is the time to mobilize the food technology to help the food supply more secure, safer and healthier, and here three possible approaches are foreseeable: First, we should continue to improve the conventional technologies. Many wholesome foods have been prepared and preserved using natural materials simply by fermentation. Second, we have to enhance the minimal processing as much as applicable. Third, new ingredients, intelligent packaging and functional foods should be explored to improve food supply and health. Today, consumer interest in the functional foods has been increased tremendously, and the future of food lies in the functional foods. However, the situations in the developing world are different from this. As food resource is limited in this region, food technology has to be emphasized to increase food supply. To help solve such complex problems, not only new technologies, but also conventional technologies have to be mobilized. Simultaneously, even higher technical capabilities have to be built up by applying new findings from the related disciplines to allow the food technology to play its vital role.

Food Handling↗

Optical imaging technology in minimally invasive surgery. Current status and future directions.

Optical engineering and imaging technology have played a major role in the evolving field of minimally invasive surgery (MIS) by making it possible to visualize the manipulation of tissue at remote internal sites. We assess and review the optical imaging technology used during a variety of MIS procedures from an engineering perspective. The field of MIS is evolving rapidly. Optic-based technologies have the potential to further improve diagnostic capabilities of MIS. Optical imaging technologies and instrument designs are discussed in relation to their current and future use in MIS procedures. Technical limitations in imaging technology are described, along with potential solutions. We review the current status and future role of optical imaging technology in MIS. In the future, synergistic benefits from engineering, imaging technology, and MIS are likely to improve diagnostic ability and patient care.

Equipment Design↗

On Heidegger, medicine, and the modernity of modern medical technology.

This paper examines medicine's use of technology in a manner from a standpoint inspired by Heidegger's thinking on technology. In the first part of the paper, I shall suggest an interpretation of Heidegger's thinking on the topic, and attempt to show why he associates modern technology with danger. However, I shall also claim that there is little evidence that medicine's appropriation of modern technology is dangerous in Heidegger's sense, although there is no prima facie reason why it mightn't be. The explanation for this, I claim, is ethical. There is an initial attraction to the thought that Heidegger's thought echoes Kantian moral thinking, but I shall dismiss this. Instead, I shall suggest that the considerations that make modern technology dangerous for Heidegger are simply not in the character - the ethos - of medicine properly understood. This is because there is a distinction to be drawn between chronological and historical modernity, and that even up-to-date medicine, empowered by technology, retains in its ethos crucial aspects of a historically pre-modern understanding of technology. A large part of the latter half of the paper will be concerned with explaining the difference.

Biomedical Technology↗

Rethinking technology, revitalizing ethics: overcoming barriers to ethical design.

This paper explores the role of ethics in design. Traditionally, ethical questions have been seen as marginal issues in the design of technology. Part of the reason for this stems from the widely held notion of technology being "out of control." This notion is a barrier to what I call "ethical design" because it implies that ethics has no role to play in the development of technology. This view, however, is challenged by recent work in the field of Science and Technology Studies (STS). Looking into the dynamics of technological change, STS scholars argue that human choices are present at every stage of a technology's development and, furthermore, that human values are reflected in the very design of artifacts. This alternative view suggests that ethics can and should be included in the design process. Drawing on examples from the privacy arena, I point to some of the potential advantages of addressing ethical concerns early on in the design of a technology. I conclude with some general strategies for bringing ethics back into design.

Ethics↗

Social science research on medical technology: utility and limitations.

Policies could be better devised and better implemented if greater use were made of the social sciences. However, the social sciences have quite often not produced knowledge adequate to permit resolution of pressing social problems. An example of both of these statements is found in the area of policies toward medical technology. Medical technology has become a major public policy issue in most industrialized countries, primarily science research has led to general formulations as to how medical technology is developed and diffused. In addition, specific studies of medical technology have identified factors that impede of facilitate the development and diffusion of medical technology. However, few studies have been done of public policy mechanisms. Effects of formal policies have not been evaluated, and organizations developed to implement policies toward medical technologies have not been studied. Programs cannot be improved without evaluation, nor can successful approaches be diffused more widely. The development and implementation of public policy toward medical technology would profit if social scientists were to become involved in its examination.

Diffusion of Innovation↗

Strategies for successful evaluation and policy-making toward health care technology on the move: the case of medical lasers.

Evaluating new health care technology that is rapidly diffusing is one of the greatest challenges to researchers and policy-makers. If no evaluation is done until the technology is mature, evaluation will not influence processes of diffusion. If evaluation is done early, it may be irrelevant when it is completed, because of developments in the technology and changing indications for its use. Nonetheless, early evaluation seems to be the only strategy possible to improve the integration of evaluation and diffusion. These difficulties are illustrated by the case of lasers. Lasers are diffusing relatively rapidly into health care, and yet few laser applications have been well-evaluated. Looking back over the past 20 years or so, only one public body, the National Eye Institute of the U.S. National Institutes of Health (NIH) seems to have tried to address the problem of laser evaluation. In the case of the Eye Institute, it has consistently identified new technologies for treatment of eye conditions and has mounted well-designed prospective evaluations aimed at influencing clinical practice. However, these evaluations have not been integrated with public policy-making, and therefore their influence has been relatively slow to develop. In recent years, concerns about technology have brought more active attempts to develop public policies to affect diffusion. Excimer laser treatment of coronary artery disease, especially as dealt with in the Netherlands, illustrates how a strategy can be developed. Regulation has allowed diffusion to be constrained while evaluation is carried out. Results of the evaluation will guide subsequent diffusion. In the future, such results will probably be used in determining if the laser treatment should be included in the benefit package of health insurance. A strategy for improving diffusion processes requires continuous monitoring of technological developments in health care to identify candidates for such early assessment. Since assessment resources are limited, setting priorities between candidates for assessment is necessary. Once priorities have been determined, an evaluative strategy can be formulated. As in the case of laser treatment of coronary disease, a mechanism for constraining diffusion until evaluations are completed is necessary. Once the studies are completed, policy-making must be done promptly. The problem of successful implementation of this strategy lies with the public bodies, which are often not prepared to develop an integrated strategy of diffusion based on technology assessment and economic appraisal. Developing such a strategy, which would involve slowing diffusion in some cases and speeding it up in others, seems to have clear benefits.(ABSTRACT TRUNCATED AT 400 WORDS)

Coronary Disease↗

Clinical applications of digital twin technology in In Vitro Fertilisation.

BACKGROUND: Digital twin technology, originating from aerospace and manufacturing industries, has emerged as a transformative tool in healthcare. In vitro fertilisation (IVF) faces persistent challenges including suboptimal embryo selection, unpredictable treatment outcomes, and limited personalisation of protocols. Despite advances in assisted reproductive technology, existing literature exhibits fragmentation: artificial intelligence applications in embryo selection, ovarian stimulation, and endometrial assessment have been developed independently without systematic integration into comprehensive treatment frameworks. Digital twin technology offers unprecedented opportunities to create virtual replicas of biological systems, enabling real-time monitoring, predictive modelling, and personalised treatment strategies. AIM: This narrative review aims to critically examine the current applications of digital twin technology in IVF, evaluate its potential benefits and limitations, synthesize existing evidence into an integrative conceptual model, and identify future directions for implementation in reproductive medicine. METHOD: A comprehensive narrative review was conducted using PubMed, Scopus, Web of Science, and IEEE Xplore databases. A narrative review approach was selected over systematic review to accommodate the heterogeneity of evidence types in this emerging field, including theoretical frameworks, simulation studies, and proof-of-concept implementations that would be excluded from systematic reviews. Search terms included "digital twin," "IVF," "in vitro fertilisation," "assisted reproductive technology," "embryo selection," and "predictive modelling." Studies published between 2015 and 2025 were included, focusing on original research articles, systematic reviews, and proof-of-concept studies describing digital twin applications in reproductive medicine. RESULTS: Digital twin technology in IVF demonstrates significant potential across multiple domains including embryo development simulation, ovarian response prediction, endometrial receptivity modelling, and personalised stimulation protocols. Current applications integrate artificial intelligence, machine learning algorithms, time-lapse imaging, and omics data to create comprehensive virtual models. Early evidence suggests improvements in embryo selection accuracy, ovarian response prediction, and treatment protocol optimization, though large-scale randomized controlled trials remain limited. Implementation challenges include data integration complexity, computational requirements, regulatory considerations, and validation requirements. CONCLUSION: Digital twin technology represents a paradigm shift in IVF practice, offering personalised, predictive, and precision medicine approaches. This review synthesizes existing evidence to propose an integrative conceptual model for digital twin implementation across the IVF treatment spectrum, identifies critical knowledge gaps, and establishes research priorities to advance clinical translation. Despite current limitations, continued advancement promises improved success rates and patient outcomes.

Humans↗

Exposure to indoor air pollution from household energy use in rural China: the interactions of technology, behavior, and knowledge in health risk management.

Indoor air pollution (IAP) from household use of biomass and coal is a leading environmental health risk in many developing nations. Much of the initial research on household energy technology overlooked the complex interactions of technological, behavioral, economic, and infrastructural factors that determine the success of environmental health interventions. Consequently, despite enormous interest in reducing the large and inequitable risks associated with household energy use in international development and global health, there is limited empirical research to form the basis for design and delivery of effective interventions. We used data from four poor provinces in China (Gansu, Guizhou, Inner Mongolia, and Shaanxi) to examine the linkages among technology, user knowledge and behavior, and access and infrastructure in exposure to IAP from household energy use. We conclude that broad health risk education is insufficient for successful risk mitigation when exposure behaviors are closely linked to day-to-day activities of households such as cooking and heating, or have other welfare implications, and hence cannot be simply stopped. Rather, there should be emphasis on the economic and infrastructure determinants of access to technology, as well as the details of behaviors that affect exposure. Better understanding of technology-behavior interface would also allow designing technological interventions that account for, and are robust to, behavioral factors or to provide individuals and households with alternative behaviors. Based on the analysis, we present technological and behavioral interventions for these four Chinese provinces.

Adult↗

A potential disruptive technology in vaccine development: gene-based vaccines and their application to infectious diseases.

Vaccine development requires an amalgamation of disparate disciplines and has unique economic and regulatory drivers. Non-viral gene-based delivery systems, such as formulated plasmid DNA, are new and potentially disruptive technologies capable of providing 'cheaper, simpler, and more convenient-to-use' vaccines. Typically and somewhat ironically, disruptive technologies have poorer product performance, at least in the near-term, compared with the existing conventional technologies. Because successful product development requires that the product's performance must meet or exceed the efficacy threshold for a desired application, the appropriate selection of the initial product applications for a disruptive technology is critical for its successful evolution. In this regard, the near-term successes of gene-based vaccines will likely be for protection against bacterial toxins and acute viral and bacterial infections. Recent breakthroughs, however, herald increasing rather than languishing performance improvements in the efficacy of gene-based vaccines. Whether gene-based vaccines ultimately succeed in eliciting protective immunity in humans to persistent intracellular pathogens, such as HIV, malaria and tuberculosis, for which the conventional vaccine technologies have failed, remains to be determined. A success against any one of the persistent intracellular pathogens would be sufficient proof that gene-based vaccines represent a disruptive technology against which future vaccine technologies will be measured.

Communicable Disease Control↗

Technology in the birthing room.

The use of technology is not benign. As with any health care intervention, there are associated risks and benefits. The practitioner needs to constantly consider the benefits of the technology versus the naturalistic birth experience. The use of technology should optimize birth outcomes while maintaining a balance that provides for the best possible human birth experience. Technology, however, does have merit in the birth setting, regardless of location, but its use should be evaluated on an individual, as needed, basis. The most common technological advances currently available for assessment and maternal/fetal care during birth include electronic fetal monitoring, ultrasonography, blood pressure screening, maternal/fetal pulse oximetry, and infusion pumps. All obstetrical care providers must be familiar with the forms of technology currently available and be aware of emerging technologies for use during the birthing process.

Biomedical Technology↗