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PubMed2006

A comprehensive survey of brain interface technology designs.

In this work we present the first comprehensive survey of Brain Interface (BI) technology designs published prior to January 2006. Detailed results from this survey, which was based on the Brain Interface Design Framework proposed by Mason and Birch, are presented and discussed to address the following research questions: (1) which BI technologies are directly comparable, (2) what technology designs exist, (3) which application areas (users, activities and environments) have been targeted in these designs, (4) which design approaches have received little or no research and are possible opportunities for new technology, and (5) how well are designs reported. The results of this work demonstrate that meta-analysis of high-level BI design attributes is possible and informative. The survey also produced a valuable, historical cross-reference where BI technology designers can identify what types of technology have been proposed and by whom.

Biotechnology↗
PubMed2000

Against over-estimating the role of ethics in technology development.

The role of ethics in technology development has been often questioned, especially in the early days of societal reflection of technology. However, the situation has changed dramatically. Ethical consideration now is generally declared to be indispensable in shaping technology in a socially acceptable and sustainable way. The expectations of ethics are large; often even a kind of "New Ethics" is postulated. In the present paper an over-estimation of the role of ethics for technology development is rejected. It is argued that ethical reflection is, indeed, indispensable in certain problem areas and situation types; but there is, on the other hand, space for technology development free from the requirement for ethical reflection. The absence of a requirement for ethical reflection, however, always has to be considered relative to some "morale provisoire" (provisional morality) as an accepted normative framework within which technology development may occur without explicit ethical reflection. If this framework, however, is doubted or is shown to be insufficient the situation changes completely. Ethical reflection in this case becomes necessary, to consider this normative framework in order to offer modifications or supplements.

Engineering↗
PubMed2002

The myth of technology in health care.

Technology is believed to have liberated health care from dogmas, myths and speculations of earlier times. However, we are accused of using technology in an excessive, futile and even detrimental way, as if technology is compelling our actions. It appears to be like the monster threatening Dr. Frankenstein or like the sorcerer's broom in the hand of the apprentice. That is, the same technology that should liberate us from myths, appears to be mythical. The objective of this article is to investigate the background for the re-entrance of the myth: How we encounter it and how we can explain it. The main point is that a myth of technology is normative: it relates 'is' and 'ought' and directs our actions. This becomes particularly clear in health care. Hence, if there is a myth of technology, it is an ethical issue, and should be taken seriously.

Delivery of Health Care↗
PubMed1989

Improving primary health care through technological innovation.

As a result of policy changes and developments on the demand side, the importance of technology in primary health care will grow fast. An approach to the implementation of new technologies in primary health care is presented in this article. First we describe the main problems in Dutch primary health care. The second step is to identify new technologies which are becoming available. Subsequently, the interface between these problems and their possible technological resolution has to be found. The fact that a technological innovation appears to be a solution is not sufficient reason for introducing it. There are all kinds of reasons why an innovation that has proved useful in the hospital situation, for example, might be of doubtful use in primary health care. Accordingly, the next step is to assess whether a technological solution to a problem in primary health care is indeed an improvement. To acknowledge the particular situation of primary health care, a scheme has been developed that may be used to determine criteria of evaluation.

Communication↗
PubMedDate not supplied

Health care technology as a policy issue.

Health care technology has become an increasingly visible issue in many countries, primarily because of the rising costs of health care. In addition, many questions concerning quality of care are being raised. Health care technology assessment has been seen as an aid in addressing questions concerning technology, including benefits and costs. A number of industrialized countries have developed active programs of health care technology assessment during the past two decades. Eight countries at similar levels of socio-economic and health development--Australia, Canada, France, Germany, the Netherlands, Sweden, the United Kingdom and the United States--have been examined to gain insights into how they manage health care technology and what place technology assessment has in such management. In addition to seeking general information, specific cases--treatment for coronary artery disease, medical imaging, laparoscopic surgery, treatment of end-stage renal disease, neonatal intensive care, and breast cancer screening--were examined in each country.

Australia↗
PubMed1987

Capital intensive hospital technology and illness: an analysis of American state data.

This paper: describes the development of a 'hospital technology index' to measure the level of capital intensive medical technology in each of the 50 U.S. states and the District of Columbia, reports differences between states in scores on this index, and tests the hypothesis that there is a low but significant negative correlation between the level of capital intensive medical technology and the level of illness. The three subscales of the hospital technology index have high alpha coefficients of reliability, are reasonably orthogonal, and there is at least some evidence of construct and discriminant validity for each. The multiple regression analysis suggests that there is either no relation between capital intensive medical technology and the rate of illness or that there is a slight tendency for the illness rate to increase as the level of technology increases. Eight possible explanations for the findings are discussed.

Financing, Government↗
PubMed1994

Technology assessment in Catalonia: integrating economic appraisal.

A brief description of the evolution and role of the Catalan Office for Health Technology Assessment (COHTA) into the framework of the Catalan Health Care Service are presented. Methodological approaches used by COHTA range from synthesis of scientific evidence to the collection of primary data. Regarding the integration of economic appraisal into technology assessment, the main approaches are the following: integration into clinical trials funded by the COHTA and in the reimbursement policies of the Catalan Health Service. COHTA participates in the process of purchasing medical technologies, especially expensive ones, and in the establishment of reimbursement policies of medical technologies. The particular characteristics of COHTA as a regional agency for Technology Assessment and its position into the framework of the Department of Health are discussed. Among the advantages of this position are the knowledge of the relevant questions for policy makers and the potential influence in the process. Among the disadvantages are the possibility of losing autonomy. Regional agencies that are closely related to the regional health services could provide a better understanding of the real problems in clinical practice and in the utilization of health technologies.

Clinical Trials as Topic↗
PubMed2003

Intelligent infrastructure for sustainable potable water: a roundtable for emerging transnational research and technology development needs.

PROBLEM STATEMENT: Recent commercial and residential development have substantially impacted the fluxes and quality of water that recharge the aquifers and discharges to streams, lakes and wetlands and, ultimately, is recycled for potable use. Whereas the contaminant sources may be varied in scope and composition, these issues of urban water sustainability are of public health concern at all levels of economic development worldwide, and require cheap and innovative environmental sensing capabilities and interactive monitoring networks, as well as tailored distributed water treatment technologies. To address this need, a roundtable was organized to explore the potential role of advances in biotechnology and bioengineering to aid in developing causative relationships between spatial and temporal changes in urbanization patterns and groundwater and surface water quality parameters, and to address aspects of socioeconomic constraints in implementing sustainable exploitation of water resources. WORKSHOP OUTCOMES: An interactive framework for quantitative analysis of the coupling between human and natural systems requires integrating information derived from online and offline point measurements with Geographic Information Systems (GIS)-based remote sensing imagery analysis, groundwater-surface water hydrologic fluxes and water quality data to assess the vulnerability of potable water supplies. Spatially referenced data to inform uncertainty-based dynamic models can be used to rank watershed-specific stressors and receptors to guide researchers and policymakers in the development of targeted sensing and monitoring technologies, as well as tailored control measures for risk mitigation of potable water from microbial and chemical environmental contamination. The enabling technologies encompass: (i) distributed sensing approaches for microbial and chemical contamination (e.g. pathogens, endocrine disruptors); (ii) distributed application-specific, and infrastructure-adaptive water treatment systems; (iii) geostatistical integration of monitoring data and GIS layers; and (iv) systems analysis of microbial and chemical proliferation in distribution systems. IMPACT: This operational framework is aimed at technology implementation while maximizing economic and public health benefits. The outcomes of the roundtable will further research agendas in information technology-based monitoring infrastructure development, integration of processes and spatial analysis, as well as in new educational and training platforms for students, practitioners and regulators. The potential for technology diffusion to emerging economies with limited financial resources is substantial.

Conservation of Natural Resources↗
PubMed2005

Artifacts and collaborative work in healthcare: methodological, theoretical, and technological implications of the tangible.

Although modeled as knowledge work with emphasis on data flow and decision making, healthcare is delivered in the context of a highly structured physical environment, with much effort and emphasis placed on physical and spatial arrangement and re-arrangement of workers, patients, and materials. The tangible aspects of highly collaborative healthcare work have profound implications for research and development of information and communication technology (ICT) despite the tendency to model work as flow of abstract data items. This article reviews field studies in healthcare and other domains on the role of artifacts in collaborative work and draws implications in three areas: methodological, theoretical, and technological. In regard to methodologies, assessment of new ICT and development of user requirements should take into account how artifacts are used and exploited to facilitate collaborative work. In regard to theories, the framework of distributed cognition provides a starting point for modeling the contribution and exploitation of physical artifacts in supporting collaborative work. In regard to technology, design and deployment of new technology should support the functions provided by physical artifacts replaced or disrupted by new technology, and profitable ways for new technology to support collaborative work by embedding ICT into existing infrastructure of physical artifacts.

Artifacts↗
PubMed1999

Nursing and the primacy of technological progress.

This article identifies assumptions common to interpreting technological progress in contemporary nursing practice. Technology is described in terms of its characteristics and progress is identified as an ideological assumption influencing the way we think about, practice, and explain technology in contemporary nursing. Arguments associated with linear development, the elimination of scarcity, the technological imperative, the advancement of nursing, and technology as a neutral phenomenon are examined. It is argued that understanding progress assists us to develop insight into the relationship between technology and nursing.

Diffusion of Innovation↗
PubMedDate not supplied

Aerospace technology transfer to breast cancer imaging.

In the United States in 1996, an estimated 44,560 women died of breast cancer, and 184,300 new cases were diagnosed. Advances in space technology are now making significant improvements in the imaging technologies used in managing this important foe. The first of these spinoffs, a digital spot mammography system used to perform stereotactic fine-needle breast biopsy, uses a backside-thinned CCD developed originally for the Space Telescope Imaging Spectrometer. This paper describes several successful biomedical applications which have resulted from collaborative technology transfer programs between the National Aeronautics and Space Administration (NASA), the National Cancer Institute (NCI), and the U.S. Dept. of Health and Human Services Office on Women's Health (OWH). These programs have accelerated the introduction of direct digital mammography by two years. In follow-on work, RTI is now assisting the HHS Office on Women's Health to identify additional opportunities for transfer of aerospace, defense, and intelligence technologies to image-guided detection, diagnosis, and treatment of breast cancer. The technology identification and evaluation effort culminated in a May 1997 workshop, and the formative technology development partnerships are discussed.

Astronomical Phenomena↗
PubMed2001

Providing information on emerging health technologies to provincial decision makers: a pilot project.

A pilot project to provide advice on new and emerging medical technologies to decision makers in a provincial health care system was undertaken by a health technology assessment (HTA) program. Briefs were prepared on technologies which were not yet available in the province and which might have a significant impact on health care. These were sent to the ministry of health and regional health authorities and made available through the agency's website. Reaction to the briefs was sought from decision makers. Decision makers in the health ministry and health authorities found the briefs helpful, and wished to continue receiving them. They had made limited use of them for planning purposes, but the briefs provided useful input to further consideration of technologies in several cases. Within the HTA program, the briefs and the process that produced them were valuable in increasing awareness of new health technologies that might require assessment in future. This pilot project demonstrated the feasibility of providing timely advice on emerging health technologies within a provincial health system. However, while decision makers found the information provided to be useful, this had not yet been integrated with provincial health care planning. Necessary machinery within policy areas and communication with the HTA process appear to be in need of development.

Canada↗
PubMed1999

Regulation of health-related technologies in Germany.

Against the background of a financial crisis and supposed inefficiencies due to inappropriate use or the use of ineffective technologies in the German health care system, increasing awareness of the role of coverage decisions and the use of health technologies has stimulated interest in the regulation of health technologies. A systematic analysis of the decision processes at the levels of licensing/market admission, coverage by statutory health insurance and steering of diffusion and usage reveals considerable inconsistencies in different health care sectors. With regard to different types of technology, an explicit licensing procedure conforming to international standards is required for drugs and medical devices. Concerning coverage decisions, the ambulatory sector appears to be much more regulated than the in-hospital sector. This applies also to diffusion and usage of technologies. However, steering of usage of health related technologies is generally weak in Germany since only non-binding guidelines are in place.

Delivery of Health Care↗
PubMed1997

Application of NASA's advanced life support technologies in polar regions.

NASA's advanced life support technologies are being combined with Arctic science and engineering knowledge in the Advanced Life Systems for Extreme Environments (ALSEE) project. This project addresses treatment and reduction of waste, purification and recycling of water, and production of food in remote communities of Alaska. The project focus is a major issue in the state of Alaska and other areas of the Circumpolar North; the health and welfare of people, their lives and the subsistence lifestyle in remote communities, care for the environment, and economic opportunity through technology transfer. The challenge is to implement the technologies in a manner compatible with the social and economic structures of native communities, the state, and the commercial sector. NASA goals are technology selection, system design and methods development of regenerative life support systems for planetary and Lunar bases and other space exploration missions. The ALSEE project will provide similar advanced technologies to address the multiple problems facing the remote communities of Alaska and provide an extreme environment testbed for future space applications. These technologies have never been assembled for this purpose. They offer an integrated approach to solving pressing problems in remote communities.

Alaska↗
PubMed2000

Meso-scale life-cycle impact assessment of novel technology policies: the case of renewable energy.

Assessing the environmental risk of novel technological systems and of the European Union (EU) policies supporting them and regulating their implementation requires good understanding of (i) the pressure on the environment posed by the large-scale use of new technology, and (ii) the vulnerability of the receptor of this pressure. Generic life-cycle assessments (LCAs) provide exhaustive accounting of environmental pressure, yet they do not take into account the vulnerability of the receiving ecosystem. Generic studies of technology externalities fail to produce conclusions on the impacts in a certain area of the systems envisaged due to lack of site-specific information. The combined use of generic (LCA) and spatially referenced data offers new opportunities for comprehensively analysing the environmental impact of novel technologies. A novel information fusion methodology is suggested. Example applications are presented herein focusing on the evaluation of renewable energy technologies as an example of the implementation of meso-scale LCA for integrated environmental risk assessment of EU technology policies.

Algorithms↗
PubMed2000

Acquisition strategies for critical care technology.

Technological advances in critical care will undoubtedly find their way into the ICU of the 21st century. The challenge for critical care practitioners is to meticulously assess these innovations and adopt the most appropriate and efficient technologies that will improve unit function and staff efficiencies, support educational programs, and most importantly, enhance patient outcome at a reasonable cost. Hospital-based intensivists have excellent opportunities to establish leadership roles in the technology evaluation process by cultivating relationships with administrators, and through active participation in the hospital-based Technology Committee and the ICU-based multidisciplinary committee. The authors' experience has left them with the lasting impression that the evaluation and introduction of new technology is time consuming and requires perseverance and patience. Ultimately, it is hoped that technological breakthroughs coupled with a standardized approach to delivery of ICU services in the coming decades will ensure better and more efficient care to critically ill patients.

Cost-Benefit Analysis↗
PubMed2000

The influence of technology on cancer nursing.

OBJECTIVES: To summarize technologies that have been described in nursing literature (in the context of oncology) over the last 25 years, and to present projections of possible technology in the future of oncology nursing. DATA SOURCES: CINAHL (1982 to present), MEDLINE (1976 to 1984), and author identification of articles. CONCLUSIONS: Technology has greatly influenced the evolution of oncology nursing, particularly concerning treatment (chemotherapy, radiation therapy, biotherapy, marrow and blood transplantation), access devices, and genetic and information technologies. IMPLICATIONS FOR NURSING PRACTICE: Nurses must be prepared to deal with how technology affects their philosophical perspective of nursing and the challenges presented by technology.

Computers↗
PubMed1995

Technology assessment. Old, new, and needs-based.

Recent health reports, including the 1993 World Development Report, have emphasized the importance of integrating the needs of the population into technology assessment. This paper reviews previous approaches to technology assessment and identifies the missing link between technology and its impact on the physical, emotional, and social needs of the community, namely needs-based technology assessment. It stresses the key role played by issues of equity and community values in making technology decisions. A number of models for needs-based technology assessment are described.

Community Health Planning↗