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PubMed1980

Policy research related to the diffusion of medical technologies.

There has been a growing interest among policy-makers in improving the transfer of preventive health technologies from research in the laboratory to application in the field. The dissemination of disease prevention technologies depends on understanding the dynamics of local acceptance and long-term commitment to such technologies by institutions, many of which do not have health as their primary responsibility. This paper describes selected national programs concerned with technology transfer and discusses a study of the adoption and implementation of one preventive health innovation---fluoride rinse procedures---as it is diffusing to public schools. Policy implications inherent in research regarding the diffusion and implementation of medical technologies are examined in terms of their relevance to those interested in assessing the school as a feasible site for delivering preventive health services and to those concerned with achieving the successful transfer of a technology from the laboratory to the field.

Communication↗
PubMed2004

Telemedicine development: setting the record straight.

When a topic so synonymous with advanced technology as telemedicine needs a written history, perhaps a discipline has come of age. Telemedicine has had an oral history among visionaries and technophiles over the last thirty years or so. Tales of grand projects, technical failures and fabulous successes abound at telemedicine meetings. One is reminded of the film footage of early efforts at flight where extravagant engineering approaches failed time and time again until the elegant solution of the Wright brothers took to the air on the beach at Kitty Hawk in December 1903. It is hard to imagine the frustration and excitement of initial efforts at telemedicine or manned flight when current expectations are for information on demand and on time departures. However, from very early efforts in telemedicine the vision was consistent: overcome the huge liability of distance in patient care by creating an electronic continuum between the site of need and the site of expertise. The vision continues to strive toward technical transparency and clinical results, which assure a patient that no matter who, no matter where, no matter when medicine will care for you with consistent professionalism. Technology took us from the patient home to the technology-rich hospital. Perhaps technology will transfer the majority of patient management back to the comforts of home, convenience of workplace or the exigencies of travel and mobility.

History, 20th Century↗
PubMed2006

Cryopreservation and transfer of pig embryos.

Recent advances in cryopreservation and non-surgical transfer of pig embryos have made embryo transfer in pigs a commercially viable technology especially for the international transfer of valuable genetic material. Early research demonstrated that early stage pig embryos were highly sensitive to temperatures below 15 degrees C and this sensitivity decreased with development to peri-hatching blastocysts which is accompanied by a reduction in lipid content. Removal of the lipid prior to freezing was found to improve the freezability and resulted in the birth of piglets. It was shown that by polarising the lipid material out of the blastomeres and using ultra rapid freezing (vitrification) the early stage zona pellucida intact embryo would also survive freezing and result in the birth of piglets. Other factors that have contributed to successful cryopreservation of the early stage pig embryo include the use of cytoskeletal stabilising agents, specific cryoprotectants, increasing cooling rates using open pulled straws or micro droplets and assisted hatching. The present review discusses the relative importance of each of these factors. The development of non-surgical transfer technology and its importance in the application of embryo transfer in the pig industry is also reviewed.

Animals↗
PubMed2006

Intellectual property and biotechnology: the U.S. internal experience--Part I.

In the development of biotechnology in the United States, many questions were raised about the appropriateness of applying to this area a traditional robust system of intellectual property rights. Despite these hesitations, the U.S. rejected suggested modifications. This was a mistake, and there is a need to develop a modified system that promotes more of the relevant ethical values.

Biomedical Research↗
PubMed2003

Translational paradigms in cerebrovascular gene transfer.

Gene transfer involves the use of an engineered biologic vehicle known as a vector to introduce a gene encoding a protein of interest into a particular tissue. In diseases with known defects at a genetic level, gene transfer offers a potential means of restoring a normal molecular environment via vector-mediated entry (transduction) and expression of genes encoding potentially therapeutic proteins selectively in diseased tissues. The technology of gene transfer therefore underlies the concept of gene therapy and falls under the umbrella of the current genomics revolution. Particularly since 1995, numerous attempts have been made to introduce genes into intracranial blood vessels to demonstrate and characterize viable transduction. More recently, in attempting to translate cerebrovascular gene transfer technology closer to the clinical arena, successful transductions of normal human cerebral arteries ex vivo and diseased animal cerebral arteries in vivo have been reported using vasomodulatory vectors. Considering the emerging importance of gene-based strategies for the treatment of the spectrum of human disease, the goals of the present report are to overview the fundamentals of gene transfer and review experimental studies germane to the clinical translation of a technology that can facilitate genetic modification of cerebral blood vessels.

Animals↗
PubMed2005

Embryo technologies and animal health - consequences for the animal following ovum pick-up, in vitro embryo production and somatic cell nuclear transfer.

Mammalian reproductive technologies that aim either to complement or to transcend conventional livestock breeding options have contributed to some of the most remarkable achievements in the field of reproductive biology in recent decades. In so doing they have extended our horizons in two distinct dimensions, the first concerning what it is technically possible to achieve and the second relating to the time-frame within which an individual's life-long developmental capability is initially established and ultimately realized or undermined. Our impressions of the benefits and values, or otherwise, of technologies such as in vitro embryo production and nuclear transfer are rightly influenced by the extent to which they impinge on the health of animals either subjected to or derived from them. Here, we consider some of the health implications of oocyte/embryo-centric technologies applied to farm livestock.

Animal Welfare↗
PubMed2003

Sexy transgenes: the impact of gene transfer and gene inactivation technologies on the understanding of mammalian sex determination.

Amongst the various developmental pathways ending in a sound mammal, sex determination presents the peculiarity of a choice between two equally viable options: female or male. Therefore, destroying a 'male-determining gene' or a 'female-determining gene' should generally not be lethal. Genetic sex determination is divided into two consecutive steps: construction of the bipotential gonad, and then sex determination per se. The genes involved in the first step are in fact involved in the development of various body compartments, and their mutation is generally far from innocuous. From transgenic and inactivation studies carried out on the laboratory mouse, a complete picture of the two steps is beginning to emerge, where the gonad itself and the necessary ducts are shown to evolve in a very coordinate way, with well-defined sex-specificities. Compared with testis determination, the ovarian side of the picture is still relatively empty, but this situation can change rapidly as candidate ovarian genes for inactivation studies are beginning to be identified.

Animals↗
PubMed1999

Transfer of behavioral intervention technology to a sexually transmitted disease clinic.

This article describes the authors' approach to introducing a behavioral counseling intervention into a local health department STD clinic setting. The goal of the intervention was to change the sexual practices of clients with STDs. The project was a collaborative effort with a local health department, school of public health, and a community training organization. The authors used an organizational change framework for implementing the intervention.

Adult↗
PubMed2001

Wireless LANs in healthcare.

Wireless local area networks (WLANs) function much like conventional LANs, except that the information they carry is transmitted using radio-frequency (RF) signals and sometimes infrared signals rather than copper or fiberoptic cables. Using devices that communicate over a WLAN has several benefits: For example, the devices can be used virtually anywhere in the facility without needing access to a hardwired data terminal, and they are often easier to install since they don't need additional wiring. But WLANs also have drawbacks. They can't transfer as much data at one time as wired systems, for example, or transfer it as quickly. Because they require new technology, they may carry greater costs. And because they operate in a frequency band that isn't protected from interference, they require special techniques to maximize the quality of their signals--techniques that, themselves, require a number of challenging decisions. In this article, we describe the basic operating and purchasing considerations involved in deciding whether to invest in WLAN technology and which type of system to choose.

Hospital Information Systems↗
PubMed1985

The development of orthopaedic appliances and low cost aids in "least developed countries".

The constant reminder of ever-increasing costs and problems in regard to medical care in industrialized countries highlights the need for simplified, low cost, orthopaedic appliances for use in the non-industrialized areas of the world. Those who are engaged in the field of Orthopaedic Technology should withstand the temptation to propagate unreservedly the technologies of industrialized nations. Nowadays the so-called "non-appropriate technologies" have become the target of frequent criticism. The transfer of technology may offer visible progress in selected areas to a limited number of people but it conceals the danger of ignoring fundamental socio-economic conditions that affect the majority of people. During the United Nations Year of the Disabled, a group of international experts unanimously came to the conclusion that the current cooperation between industrialized and Third World countries requires revision leading to a new order. The consensus demanded a new emphasis on the development of technical orthopaedic services which would take into account the unique economic, social, cultural and environmental factors of each region. This paper examines the practices of technical orthopaedics in a "least developed country" and lays down principles and practical applications which could serve as a foundation for a more appropriate approach in this field.

Developing Countries↗
PubMed1998

Mesenchymal stem cells in osteobiology and applied bone regeneration.

Bone marrow contains a population of rare progenitor cells capable of differentiating into bone, cartilage, muscle, tendon, and other connective tissues. These cells, referred to as MSCs, can be purified and culture expanded from animals and humans. This review summarizes recent experimentation focused on characterizing the cellular aspects of osteogenic differentiation, and exploration of the potential for using autologous stem cell therapy to augment bone repair and regeneration. The authors have completed an array of preclinical studies showing the feasibility and efficacy of MSC based implants to heal large osseous defects. After confirming that syngeneic rat MSCs could heal a critical size segmental defect in the femur, it was established that human MSCs form bone of considerable mechanical integrity when implanted in an osseous defect in an immunocompromised animal. Furthermore, bone repair studies in dogs verify that the technology is transferable to large animals, and that the application of this technology to patients at geographically remote sites is feasible. These studies suggest that by combining MSCs with an appropriate delivery vehicle, it may be possible to offer patients new therapeutic options.

Animals↗