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PubMed2005

A systematic review of interactive computer-assisted technology in diabetes care. Interactive information technology in diabetes care.

BACKGROUND: Excellent diabetes care and self-management depends heavily on the flow of timely, accurate information to patients and providers. Recent developments in information technology (IT) may, therefore, hold great promise. OBJECTIVE: To determine, in a systematic review, how emerging interactive IT has been used to enhance care for adults with type 2 diabetes. METHOD: Eligible studies were randomized controlled trials (RCTs) and observational studies (both before-after designs and post-intervention assessments) focused on computer-assisted interactive IT that included > or =10 adults with diabetes (> or =50% type 2) and reported in English. We searched 4 electronic databases (up to 2003) using terms for diabetes and technology, reviewed bibliographies, and handsearched Diabetes Care (January 1990 to February 2004). Two reviewers independently selected articles and worked serially on data extraction with adjudication of discrepancies by consensus. RESULTS: There were 26 studies (27 reports): internet (n=6; 3 RCTs), telephone (n=7; 4 RCTs), and computer-assisted integration of clinical information (n=13, 7 RCTs). The median (range) sample size was 165 (28 to 6,469 participants) for patients and 37 (15 to 67) for providers; the median duration was 6 (1 to 29) months. Ethnic minorities or underserved populations were described in only 8 studies. Six of 14 interventions demonstrated moderate to large significant declines in hemoglobin A1c levels compared with controls. Most studies reported overall positive results and found that IT-based interventions improved health care utilization, behaviors, attitudes, knowledge, and skills. CONCLUSIONS: There is growing evidence that emerging IT may improve diabetes care. Future research should characterize benefits in the long term (>1 year), establish methods to evaluate clinical outcomes, and determine the cost-effectiveness of using IT.

Biomedical Technology↗
PubMedDate not supplied

Selection factors in the choice of immunoassay technology: implementing technology in the new era.

Centralized Laboratory Services, Inc. is a large, freestanding laboratory that underwent a major equipment reconfiguration for the performance of endocrine/tumor marker/anemia assays (N = 15) in August 1995. Before the transition these assays were done on six instruments, none of which were computer interfaced. All assays were subsequently consolidated on four ACS-180+ instruments (Chiron Diagnostics, Norwood, MA), which were interfaced to our laboratory information system (Cerner Corp, Kansas City, MO). Our experience suggests that significant increases in productivity and reductions in cost are possible through instrument upgrades. Both laboratory-specific and analytical system-specific factors were found to be important in the optimal selection of immunoassay technology. As laboratorians necessarily adjust to changing economic and organizational circumstances and are compelled to "do more with less," technology assessment will become an increasingly important function for senior laboratory management.

Clinical Laboratory Information Systems↗
PubMed1999

[The International Network of Agencies for Health Technology Assessment (INAHTA) or the need for collaboration in evaluating health technologies].

Given the current situation of globalization, rapidity of changes and open market, the problems in the health care sector also go beyond the local boundary. Thus, it is frequent for different health systems to have similar evaluation needs. The assessment reports are among the main tools that assessment agencies use to communicate with the health care professionals and policy makers in any responsibility: politics, management, or clinical care. Occasionally different evaluation teams have to deal with similar topics. It is in this context, with the aim to avoid duplicity and to join efforts, that the idea of collaboration within assessment agencies started, with an obvious benefit to all of them. The International Network of Agencies for Health Technology Assessment (INAHTA) was created with the aim of serving as a forum to identify common interests of agencies for health technology assessment. In these five years, a lot of activities and important outcomes have been achieved. Among others, we can mention the implementation of data bases with all the information produced by the member agencies, the establishment of an Internet Web site, the periodical publication of the newsletter, the joint assessment projects and the collaboration with developing countries. New projects for the future are currently under discussion.

Cooperative Behavior↗
PubMed2002

MBR-technology in municipal wastewater treatment: challenging the traditional treatment technologies.

In The Netherlands a development programme for the application of the MBR technology in municipal wastewater treatment has started. This paper briefly describes this development programme and goes into detail for the first step: a large pilot plant study at the Beverwijk WWTP. Under the supervision of DHV Water four different membrane systems from Kubota, Mitsubishi, X-Flow and Zenon were extensively tested. The objectives set for the study were more than achieved. The available world knowledge regarding municipal MBR was extremely limited and often very specific for a particular country's wastewater and wastewater flow characteristic. The conditions set by the Dutch situation were the first of its kind and lead to new methods of MBR optimisation. After almost two years of intensive research and further development of the technological feasibility of the MBR for The Netherlands, it has been decided to extend it to demonstration scale.

Bioreactors↗
PubMed2003

[The links between technology and specialist practice in rehabilitation: the model of gymnastic technology in 19th century Spain].

Gymnastic technology had a decisive role in the configuration of a particular medical specialty, Physical Medicine and Rehabilitation. Its study is critical to understand the strong division of work roles that existed in this field, with a medical specialty and several professions linked to physiotherapy and rehabilitation. This process was developed in two well-defined phases: the assimilation of the knowledge and technological advances of gymnasts at the beginning of the 19th century, and the appropriation of the use of these appliances by doctors. Both factors favoured the emergence of the new professions.

Biomedical Technology↗
PubMed2004

Technology in medical education: how the OU College of Medicine has used technology to enhance the medical education experience.

The authors briefly review traditional medical education teaching methods and present a description of new developments at the OU College of Medicine using computers and advanced technologies for the enhancement of medical education. The focus is on how computers, educational facilities, online curriculum, medical simulation devices and other technologies are changing the way medical students learn.

Curriculum↗
PubMed2006

Theory development in health care informatics: Information and communication technology acceptance model (ICTAM) improves the explanatory and predictive power of technology acceptance models.

The purpose of this web-based study was to explain and predict consumers' acceptance and usage behavior of Internet health information and services. Toward this goal, the Information and Communication Technology Acceptance Model (ICTAM) was developed and tested. Individuals who received a flyer through the LISTSERV of HealthGuide were eligible to participate. The study population was eighteen years old and older who had used Internet health information and services for a minimum of 6 months. For the analyses, SPSS (version 13.0) and AMOS (version 5.0) were employed. More than half of the respondents were women (n = 110, 55%). The average age of the respondents was 35.16 years (S.D. = 10.07). A majority reported at least some college education (n = 126, 63%). All of the observed factors accounted for 75.53% of the total variance explained. The fit indices of the structural model were within an acceptable range: chi2/df = 2.38 (chi2 = 1786.31, df = 752); GFI = .71; RMSEA = .08; CFI = .86; NFI = .78. The results of this study provide empirical support for the continued development of ICTAM in the area of health consumers' information and communication technology acceptance.

Adult↗
PubMed1995

Automated medical records technology at the National Cancer Institute-Egypt: a case study in technology transfer.

The National Cancer Institute-Cairo, Egypt (NCI) has adopted three different approaches to the automated medical record. These approaches are: the use of an integrated hospital information system, a document scanning system, and an imaging system. This paper discusses each of these approaches with regard to its benefits, technology-implemented and technology-related issues, and the social and cultural differences between implementations in developed and developing countries.

Egypt↗
PubMed1993

Assisted reproductive technology in the United States and Canada: 1991 results from the Society for Assisted Reproductive Technology generated from the American Fertility Society Registry.

OBJECTIVE: To summarize the procedures and outcomes of assisted reproductive technology (ART) initiated in the United States in 1991. DESIGN: Data were collected on an annual summary form and submitted to the Society for Assisted Reproductive Technology generated from The American Fertility Society central registry. PARTICIPANTS: Two hundred fifteen programs submitted data on procedures performed in 1991. Data were collected in October of 1992 so that outcome of all pregnancies established would be known. MAIN OUTCOME MEASURES: The outcomes measured included clinical pregnancy, ectopic pregnancy, abortion, stillbirth, delivery, and congenital abnormality. RESULTS: In 1991, programs reported initiation of 33,001 cycles of ART treatment, excluding frozen embryo and donor oocyte cycles. Of these, 24,671 cycles initiated were IVF with 15.2% deliveries per retrieval, 5,452 were cycles of GIFT with 26.6% deliveries per retrieval, and 2,104 were cycles of zygote intrafallopian transfer with 19.7% deliveries per retrieval, and 714 were combination cycles, combining IVF and one of the tubal transfer techniques, resulting in 19.3% deliveries per retrieval. In addition to these cycles initiated in 1991, 4,838 frozen embryo procedures were reported, either as separate procedures or in combination with another ART procedure with 11.1% deliveries per procedure, and 1,107 donor oocyte or surrogacy cycles were initiated with an overall success of 25.6% deliveries per retrieval. From all of these procedures, a total of 5,699 deliveries were reported. CONCLUSIONS: In 1991, there were more programs offering more treatment cycles of ART. Average success rates for most ART procedures exhibited a small increase compared with previously reported summaries.

Adult↗
PubMed1994

Assisted reproductive technology in the United States and Canada: 1992 results generated from the American Fertility Society/Society for Assisted Reproductive Technology Registry.

OBJECTIVE: To summarize the procedures and outcomes of assisted reproductive technology (ART) initiated in the United States in 1992. DESIGN: Data were collected on an annual summary form and submitted to The American Fertility Society/Society for Assisted Reproductive Technology Registry. PARTICIPANTS: Two hundred forty-nine programs submitted data on procedures performed in 1992. Data were collected in October 1993 so that outcome of all pregnancies established would be known. MAIN OUTCOME MEASURES: The outcomes measured included clinical pregnancy, ectopic pregnancy, abortion, stillbirth, delivery, and congenital abnormality. RESULTS: Programs reported initiations of 37,955 cycles of ART treatment, excluding frozen embryo and donor oocyte cycles. Of these, 29,404 cycles initiated were IVF with 16.8% deliveries per retrieval, 5,767 were cycles of GIFT with 26.3% deliveries per retrieval, 1,993 cycles of zygote intrafallopian transfer with 22.8% deliveries per retrieval, and 791 were combination cycles, combining IVF and one of the tubal transfer techniques, resulting in 27.9% deliveries per retrieval. In addition to these cycles initiated in 1992, 5,814 frozen ET procedures were reported, either as separate procedures or in combination with another ART procedure, with 13.9% deliveries per procedure, and 2,032 donor oocyte or surrogacy cycles were initiated with an overall success of 31.3% deliveries per retrieval. As a result of all procedures, a total of 7,355 deliveries were reported. CONCLUSIONS: In 1992, there were more programs offering more treatment cycles of ART. Average success rates exhibited only a small increase compared with previously reported summaries.

Adult↗
PubMed1998

Otolaryngology in the information age: enabling technologies for the future of surgery. Enabling technologies for the future of surgery.

Enabling technologies for the future, whether exemplified by endoscopic, minimally invasive, or microdexterity systems or surgical and nonsurgical image-guided procedures, continue with an evolution so rapid that before one change has been accepted and perfected, another even more dramatic change promises to replace it. These information-based surgical and procedural interventions are just now becoming accepted standards of surgical, radiologic, and medical practice, and yet the promise of more advanced technologies blurs even these new boundaries, constantly redefining the concept of "surgery." It is essential that otolaryngologists, as part of the broader spectrum of physicians, understand these changes and prepare to adapt and improve each and every one of their technical and cognitive skills.

Computer Simulation↗
PubMed1993

Defusing technology. Technology diffusion in British Columbia.

In order to explore the diffusion of the selected technologies in one Canadian province (British Columbia), two administrative data sets were analyzed. The data included over 40 million payment records for each fiscal year on medical services provided to British Columbia residents (2,968,769 in 1988) and information on physical facilities, services, and personnel from 138 hospitals in the province. Three specific time periods were examined in each data set, starting with 1979-80 and ending with the most current data available at the time. The detailed retrospective analysis of laboratory and imaging technologies provides historical data in three areas of interest: (a) patterns of diffusion and volume of utilization, (b) institutional profile, and (c) provider profile. The framework for the analysis focused, where possible, on the examination of determinants of diffusion that may be amenable to policy influence.

British Columbia↗
PubMedDate not supplied

Microbiological aspects and technological need: technological needs for nitrates and nitrites.

Nitrate and nitrite are used in meat and fish curing, and in the manufacture of certain cheeses. Nitrate itself has little antimicrobial effect and in most applications could be replaced by lower concentrations of nitrite. Further, improved hygiene diminishes the need for nitrite. The antimicrobial activity and technological needs for nitrate and nitrite are reviewed. It is concluded that the technological needs for nitrite in meat products stored at < 10 degrees C could be met by added nitrite concentrations of 50 mg/kg. The overall effect of nitrate in salted fish appears to be marginal. In such products, Vibrio parahaemolyticus does not grow at salt concentrations of 10% and food poisoning by this organism is not related to the absence of nitrate or nitrite; growth of Clostridium botulinum Type E (the predominant cause of botulism from fish products) is arrested by salt concentrations of 3-4%. Listeria monocytogenes in seafood cannot be controlled by nitrite. The use of nitrate in cheese production could be avoided, or at least reduced to a low level by avoiding silage with a high count of gas-producing Clostridia and hygienic milk collection.

Bacteria↗
PubMed1983

Citrus fruits--varieties, chemistry, technology, and quality evaluation. Part II. Chemistry, technology, and quality evaluation. A. Chemistry.

In Part 2 of this review on citrus fruits, the literature on chemistry, technology, and quality evaluation are critically considered. Sweet oranges, mandarin, grapefruit, lemon, and lime are generally used for processing. The literature on chemical components of citrus fruit which include sugars, polysaccharides, oraganic acids, nitrogenous constituents and lipids; carotenoids which contribute to color; vitamins and minerals, and flavonoids; limonoids, some of which impart bitterness to the juice; and the volatile components which contribute to aroma have been reviewed. Chilled and pasteurized juices, juice concentrates, and beverages are the important products manufactured commercially, and to a limited extent powdered citrus juices, canned segments, and marmalades. The literature on the manufacture of these products also as new types of juice and oil extractors; TASTE and other types of evaporators; tank farms to store juice and concentrate in bulk; aseptic filling in bulk containers and retail packs; alternate flexible and rigid containers other than glass and tin; and recovery of volatile flavoring constituents during juice processing are some of the important technological developments in the recent past and have been discussed. Bitterness in citrus juices and its control, composition of cloud, and its stability and changes during storage have been reviewed. Essential oils, pectin, frozen and dried juice sacs, dried pulp and molasses, flavonoids, seed oil, and meal are the important byproducts, the manufacture of which is given in essential details. Generally, consumers judge the product on the basis of its sensory attributes. The quality of finished product is dependent upon the raw materials used and control of processes. The U.S. Department of Agriculture (USDA) standards for different products, physicochemical and microbiological parameters prescribed as indices of quality of fruit, juice, concentrate, and other products; composition of essential oils; and aroma concentrates are discussed in relation to sensory quality. Analytical methods for compounds affecting quality, and methods for detection of adulteration in different citrus products are briefly reviewed. The importance of sensorily evaluating quality of citrus products to select and develop quality control indices is emphasized. Areas where further research are required are indicated. A comprehensive bibliography is provided to aid further study and research.

Beverages↗
PubMed2002

Cutting-edge technology. II. Proteomics: core technologies and applications in physiology.

Technologies for proteomics, e.g., studies examining the protein complement of the genome, have been in development for over 20 years. More recently, proteomics has become formalized by combining techniques for large-scale protein separation with very precise, high-fidelity approaches that analyze, identify, and characterize the separated proteins. These methods bring to reality the powerful scope of proteomics, enabling researchers to investigate cellular function at the protein level and thus representing one of proteomics' most fitting applications. In this review, we take a brief and concise look at some of the current, physiologically relevant technologies that comprise proteomics and report specific applications in which proteomics has provided valuable biological insight.

Animals↗
PubMed2004

Emergent FDA biodefense issues for microarray technology: process analytical technology.

A successful biodefense strategy relies upon any combination of four approaches. A nation can protect its troops and citizenry first by advanced mass vaccination, second, by responsive ring vaccination, and third, by post-exposure therapeutic treatment (including vaccine therapies). Finally, protection can be achieved by rapid detection followed by exposure limitation (suites and air filters) or immediate treatment (e.g., antibiotics, rapid vaccines and iodine pills). All of these strategies rely upon or are enhanced by microarray technologies. Microarrays can be used to screen, engineer and test vaccines. They are also used to construct early detection tools. While effective biodefense utilizes a variety of tactical tools, microarray technology is a valuable arrow in that quiver.

Bioterrorism↗
PubMedDate not supplied

Measuring hospital readiness for information technology (IT) innovation: A multisite study of the Organizational Information Technology Innovation Readiness Scale.

The Institute of Medicine has stressed the need for health care organizations to increase their use of information technology (IT) to create safer health care environments, particularly in the area of medication safety. However, the rate of successful organizational IT innovation remains low and this is primarily attributed to a lack of organizational IT innovation readiness. The reported study completes the fourth phase in the development of the 48-item Organizational Information Technology Innovation Readiness Scale (OI-TIRS). The aim of this study was to re-examine the psychometric adequacy of the OITIRS to determine the readiness of three community hospitals to implement a commercial computerized provider order entry (CPOE) medication safety system. Findings supported internal consistency reliability with alpha coefficients from .78 to .92, and mean interitem correlations for the eight subscales ranging from .38 to .65 with a significance level of .01. Construct validity was supported with an overall factor loading range of .49 to .92 across the eight subscales and an explained variance ranged from 33% to 66%. The study findings supported the use of the OITIRS to assess hospital readiness for computer provider order entry system innovation.

Adult↗
PubMed2006

In vivo induced antigen technology (IVIAT) and change mediated antigen technology (CMAT).

In this chapter, an overview of in vivo induced antigen technology (IVIAT) and change mediated antigen technology (CMAT) will be presented, including a discussion of the advantages and limitations of these methods. Over fifteen different microbial pathogens have been or are known to be currently studied with these methods. Salient data obtained from the application of IVIAT and/or CMAT to a selection of human and plant pathogens will be summarized. This includes recent reports on Streptococcus pyogenes (Group A) in neurological disorders and invasive diseases, Xylella fastidiosa in Pierce's disease, Xanthomonas campestris in bean blight, Salmonella enterica serovar typhi in typhoid fever and Leishmania spp. related infections. Special emphasis will be given to those targets that have been further investigated for the development of novel vaccine, diagnostic and/or antibiotherapy strategies. This encompasses a new point-of-care serological diagnostic test for chronic periodontal diseases. Finally, Mycobacterium tuberculosis in vivo induced products will be described as providing a rational basis for differentiating subjects with primary, dormant or secondary tuberculosis infections, from control subjects who have or did not have prior vaccination with BCG.

Animals↗