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PubMed1999

New technologies for making vaccines.

Technologies for making active vaccines fall into 3 general groups: live, subunit (killed or inactivated) and genetic. Each of these groups is further divisible into multiple categories, which include recombinant-derived antigens as well as native microorganisms and their components. In addition, there are new enabling technologies such as delivery systems and vectors which can be applied to these approaches. Most disease targets, whether infectious or noninfectious in origin, can be approached by the application of several different vaccine technologies, as can be tested during the discovery phase of research. The criteria for choosing early in a development program which of the vaccine technologies are likely to ultimately be most fruitful for a given application include: knowledge of the pathogenesis of the given infection/disease; technical feasibility; immunobiology and associated mechanisms; preclinical efficacy profile; anticipated clinical safety; regulatory; manufacturing; and marketing. All of these criteria should be considered together in making selections for an R&D program. This paper is reviewing the major vaccine technologies and relevant examples of how these criteria are used to make decisions in vaccine development.

Animals↗
PubMed2000

Technology, selfhood and physical disability.

Much has been written in recent times of the interface between technologies and the human body. The vast majority of this literature, however, focuses on a body that is assumed to be free of physical disability. This article seeks to address this lacuna by presenting findings from an exploratory study using in-depth interviews with fifteen people with physical disabilities living in the Australian city of Adelaide. The dominant research question was to explore the ways in which technologies contribute to the meanings and experiences of the lived body/self with disabilities. The data showed that the interviewees identified several technologies that they used as highly beneficial to allowing them to transcend some aspects of their disabilities. However, the interviewees also identified significant negative aspects to the use of some technologies. They noted that such technologies could serve to mark out people with disabilities as 'different' or 'lacking', acting as a barrier to the achievement and presentation of their preferred body/self.

Persons with Disabilities↗
PubMed2001

Evaluation of two lead-based paint removal and waste stabilization technology combinations on typical exterior surfaces.

A study was conducted to demonstrate the effectiveness of a wet abrasive blasting technology to remove lead-based paint from exterior wood siding and brick substrates as well as to evaluate the effectiveness of two waste stabilization technologies to stabilize the resulting blast media (coal slag and mineral sand) paint debris thereby reducing the leachable lead content. The lead-based paint removal technology effectiveness was determined by the use of an X-ray fluorescence (XRF) spectrum analyzer (L- and K-shell). The effectiveness of the technologies to stabilize the debris was evaluated through the toxicity characteristic leaching procedure (TCLP). Wet abrasive blasting effectively removed the lead-based paint coating from both the wood and brick substrates to below the US Department of Housing and Urban Development Guideline (1mg/cm(2)) with no minimal or no damage to the underlying substrates (P<0.0001). The mean area air levels of lead-containing particulate generated during paint removal were significantly below the personal exposure limit (PEL) (P<0.0001). However, the mean personal breathing zone lead levels were approximately three times higher than the PEL. Neither of the two stabilization technologies consistently stabilized the resultant paint debris to achieve a leachable lead content below the RCRA regulatory threshold of <5 mg/l.

Air Pollution, Indoor↗
PubMed1987

Computer technology: state of the art and future trends.

Computer technology and, more broadly, information technology, are bringing about a fundamental transformation in our society from an industrial economy to an information economy. A review of the short history and present state of information technology identifies two major undercurrents: the miniaturization of computer components, which has produced a millionfold increase in the complexity possible in a single chip of silicon, and the integration of four previously separate areas of information technology: computation, communication, databases and the user interface. Microelectronics, computer networks, data storage and user amenities are the basic technologies that support these four areas and stimulate their progress. Future trends in speech recognition, voice synthesis, artificial intelligence, expert systems, computational imaging and scientific workstations are also examined.

Artificial Intelligence↗
PubMed2003

Biodegradable microparticles for sustained release of a new GnRH antagonist--part I: Screening commercial PLGA and formulation technologies.

The formulation of a new GnRH antagonist (degarelix) in biodegradable poly(DL-lactide-co-glycolide) (PLGA) microparticles was investigated for the development of a 3-month sustained release formulation to treat prostate cancer. The aim was to screen formulation technologies and distinct copolymers to produce microparticles (MP) of different types with good entrapment efficiency (>85%) and peptide purity (>95%) after gamma sterilization. Basically, three types of degarelix-loaded MP (4, 8 and 16% w/w nominal content) were produced with solvent and non-solvent technologies, namely double-emulsion solvent evaporation, spray-drying and two extrusion methods. Besides composition, commercial copolymers differing in residual monomer content and functional group at the carboxylic terminus (acid or ester) were characterized and employed. Peptide loading capacity and purity, as well as shape, size characteristics, and porosity of the produced microparticles were discussed in relation to technology and copolymer choice. Spray-drying and micro-extrusion were the two preferred formulation technologies because of higher entrapment efficiency and better preservation of peptide purity during production and gamma-sterilization. The impact of formulation technologies on the MP characteristics overwhelmed the impact of copolymer selection. Nevertheless, one particular polymer was discarded since it was more susceptible towards radiolytic degradation. The resulting degarelix-MP will be tested in a biological assay for selection of the formulation based on performance.

Biotransformation↗
PubMed1998

Computer and information technology: hardware.

Computers open the door to an ever-expanding arena of knowledge and technology. Most nurses practicing in perianesthesia setting were educated before the computer era, and many fear computers and the associated technology. Frequently, the greatest difficulty is finding the resources and knowing what questions to ask. The following is the first in a series of articles on computers and information technology. This article discusses computer hardware to get the novice started or the experienced user upgraded to access new technologies and the Internet. Future articles will discuss start up and usual software applications, getting up to speed on the information superhighway, and other technologies that will broaden our knowledge and expand our personal and professional world.

Computer Communication Networks↗
PubMed1987

Economic forces and hospital technology. Lessons from the United States experience.

This paper considers economic forces on the organization and use of technology in hospitals from a U.S. perspective. U.S. hospitals are moving from a period of very loose financial constraints to one in which the demand side of the market is likely to exert much greater discipline. Theory and limited evidence suggest some important effects on the adoption and use of technology, leading in general to more emphasis on cost reduction and less emphasis on costly quality improvements. Also discussed are economic influences on the movement of technology out of the hospital and on the development of new technologies. Finally, some peculiarities of very high cost technologies are noted.

Ambulatory Care↗
PubMed1987

Economic forces and hospital technology. A perspective from Europe.

The paper considers the economic characteristics of technology and suggests a categorization based on the economic nature of particular technologies and their effect on the product health care that may be helpful in considering the economics of technology in hospitals. It reviews the range of economic forces that might be expected to apply to the use of technology in the hospital setting, and notes some of the evidence to support such hypotheses. In considering the limited evidence from the United Kingdom and elsewhere in Europe, the paper contrasts its focus on socio-political, institutional, and organizational factors, rather than the direct economic factors considered in the United States work. It suggests that the multiplicity of forces at work make cross-national, empirical, and policy analyses very difficult. Indeed, without more economic appraisal the effect of differences in technology adoption cannot be evaluated.

Diffusion of Innovation↗
PubMed1989

High technology and psychiatric care of the elderly.

The dramatic explosion of scientific information, as well as the development of computerized devices in medicine, will continue to change both the diagnosis and treatment of the elderly as it changes our entire culture. There are many technological forces now combining to push the frontiers of knowledge about the brain to new levels. This article outlines these new scientific and technological frontiers in psychiatric diagnosis including: diagnostic imaging, computer EEG, and psychiatric evaluation; treatment including health-related computerized aids, computerized psychopharmacology, neuropsychiatric training for handicapped and brain-injured, and chronic care; and medical education. This article discusses some of the issues that arise due to these new developments. Computers have multiplied the kinds of questions that can be meaningfully asked. In this way, the advent of the computer has opened the minds of many researchers to new frontiers. An important question is, "What will the psychiatric 'state of the art' be in a technological age?" Other issues include confidentiality with new devices, use of high technology to define malpractice liability, the lack of professional standards in software, the resistance of medical profession to computers, and the increased ability to misuse statistics. Geriatric psychiatrists must take an active role in planning the future impact of high technology in our field.

Aged↗
PubMed2001

Determinants of information technology outsourcing among health maintenance organizations.

We analyze the determinants of HMO information technology outsourcing using two studies. Study 1 examines the effect of asset specificity on outsourcing for development and operation activities, using HMO specific fixed effects to control for differences between HMOs. Study 2 regresses the HMO specific fixed effects from Study 1, which measure an HMO's propensity to outsource, on HMO characteristics. The data comes from a 1995 InterStudy survey about information technology organization of HMOs. While HMOs split roughly equally in outsourcing information technology development activities, they are extremely unlikely to outsource the day-to-day operation of information systems. The greater an HMO's information technology capability and the complexity of information systems supported, the less likely is an HMO to outsource. While HMOs less than two years old, for-profit HMOs, local or Blue Cross-affiliated HMOs, and mixed HMOs are more likely to outsource, federally qualified HMOs are less likely to outsource. Policy and managerial implications for the adoption and diffusion of new ways of organizing information technology, such as application service providers (ASPs), are discussed.

Decision Making, Organizational↗
PubMed1999

Gambling Technologies: Prospects for Problem Gambling.

Technology his always played a role in the development of gambling practices and will continue to play a critical role in the development of increased gambling opportunities (e.g., internet gambling). Although technological advance his long been associated with improved gambling opportunities, there is little written in the literature explicitly pointing out this link and its implications for problem gamblers. This paper therefore reviews this situation and examines the technological implications of situational and structural characteristics paying particular attention to slot machine gambling as there has been more empirical work on this type of gambling than any other technological form. The impact of technology on the sociability of gambling is also examined followed by a more speculative evolution of internet gambling as an area of potential concern.

Journal Article↗
PubMed2003

Penetration of medication safety technology in community hospitals.

Results of a survey of medication safety technology in community hospitals are presented. A written questionnaire was mailed to pharmacy directors at 88 hospitals located in 21 states. Items in the questionnaire addressed current and planned use of technology intended to improve medication safety. Fifty-six usable responses were received for a response rate of 63.6%. Medication safety was considered one of the most important issues facing pharmacy departments. Barriers identified by respondents to the implementation of medication safety initiatives included lack of time and personnel. Most hospitals had implemented one or more different types of medication safety technology. Computer-generated or electronic medication administration records, pharmacy computer systems interfaced with laboratory values, and unit-based medication dispensing cabinets were the most common medication safety technologies used. Pharmacy managers perceived these technologies to have resulted in a reduction in the rate of medication errors in respondent hospitals.

Hospitals, Community↗
PubMed2000

Enhancing technology skills of maternal and child health professionals.

OBJECTIVE: Information technology skills are essential for effective and efficient practice in maternal and child health (MCH). METHODS: Prior to the beginning of a web-based analytic skills training course, enrolled MCH professionals confidence in using e-mail and other Internet skills and beliefs about their usefulness were assessed. RESULTS: The assessment showed that participants believed strongly in the value of the specific technology skills but confidence in the ability to use these skills was low. CONCLUSION: An online technology skills training module was developed based on skills needed for the course to ensure that course participants learned and practiced the technology skills necessary to successfully complete the online analytic skills course. We describe the development, implementation, and results of the online technology skills module.

Administrative Personnel↗
PubMed2003

Craniofacial imaging informatics and technology development.

PURPOSE: 'Craniofacial imaging informatics' refers to image and related scientific data from the dentomaxillofacial complex, and application of 'informatics techniques' (derived from disciplines such as applied mathematics, computer science and statistics) to understand and organize the information associated with the data. METHOD: Major trends in information technology determine the progress made in craniofacial imaging and informatics. These trends include industry consolidation, disruptive technologies, Moore's law, electronic atlases and on-line databases. Each of these trends is explained and documented, relative to their influence on craniofacial imaging. RESULTS: Craniofacial imaging is influenced by major trends that affect all medical imaging and related informatics applications. The introduction of cone beam craniofacial computed tomography scanners is an example of a disruptive technology entering the field. An important opportunity lies in the integration of biologic knowledge repositories with craniofacial images. CONCLUSION: The progress of craniofacial imaging will continue subject to limitations imposed by the underlying technologies, especially imaging informatics. Disruptive technologies will play a major role in the evolution of this field.

Databases as Topic↗
PubMed2004

Towards an embryocentric world: the current and potential uses of embryo technologies in dairy production.

Structural features of the dairy industry make it well situated to use embryo technologies as tools for enhancing the genetic merit of dairy cattle and improving fertility. Technologies dependent upon embryo transfer have the potential to increase the efficiency of quantitative genetic selection as well as marker-assisted selection, simplify cross-breeding and germplasm conservation procedures and allow incorporation of transgenes into dairy cattle. In addition, embryo technologies may prove useful in improving fertility in infertile populations of lactating cows. The realisation of the promise of embryo technologies has been constrained by suboptimal efficiency in the production of embryos, alterations in embryonic and fetal survival and development associated with in vitro embryo production and cloning, as well as other technical and societal concerns. Solutions to many of these constraints are possible and the use of embryo technologies in both nucleus and commercial herds is likely to increase. Eventually, embryo transfer may compete with artificial insemination as a dominant method for establishing pregnancies in dairy cattle.

Animals↗
PubMed2003

Investing in new technology: the PET experience.

As funding available to health services is limited, demonstrating the cost effectiveness of new technologies is an important step in their introduction. This is especially challenging for diagnostic technologies, for which the usual paradigm of reliance on well-designed, randomised controlled trials may not be appropriate. A recently completed Health Technology Assessment of fluorine-18 deoxyglucose (FDG)-positron emission tomography (PET) imaging in cancer management, focused on addressing whether the introduction of PET imaging would be beneficial to patients in the NHS in Scotland, exemplifies some of the challenges. Although a substantial body of published literature exists for this technology, most of the studies report diagnostic accuracy rather than improved patient outcomes. Direct evidence that such improvement occurs, and is sufficient to meet the NHS' criteria for cost effectiveness, from well-designed trials would constitute the most immediately persuasive case for the introduction of PET imaging. In the absence of such evidence, collaboration is required between a variety of disciplines to synthesise evidence from a variety of sources to create informative decision models that estimate long-term patient outcomes. The use of such decision models enabled the Health Technology Board for Scotland (now a part of NHS Quality Improvement Scotland) to determine that FDG-PET imaging is likely to be cost effective in selected applications and identified long-term patient benefits that it would not be possible to study in a randomised controlled trial.

Cost-Benefit Analysis↗
PubMed2003

Advantages and limitations of microarray technology in human cancer.

Cancer is a highly variable disease with multiple heterogeneous genetic and epigenetic changes. Functional studies are essential to understanding the complexity and polymorphisms of cancer. The final deciphering of the complete human genome, together with the improvement of high throughput technologies, is causing a fundamental transformation in cancer research. Microarray is a new powerful tool for studying the molecular basis of interactions on a scale that is impossible using conventional analysis. This technique makes it possible to examine the expression of thousands of genes simultaneously. This technology promises to lead to improvements in developing rational approaches to therapy as well as to improvements in cancer diagnosis and prognosis, assuring its entry into clinical practice in specialist centers and hospitals within the next few years. Predicting who will develop cancer and how this disease will behave and respond to therapy after diagnosis will be one of the potential benefits of this technology within the next decade. In this review, we highlight some of the recent developments and results in microarray technology in cancer research, discuss potentially problematic areas associated with it, describe the eventual use of microarray technology for clinical applications and comment on future trends and issues.

Breast Neoplasms↗
PubMed2004

Learning of dynamic display AAC technologies by typically developing 3-year-olds: effect of different layouts and menu approaches.

The present study investigated the learning demands of dynamic display augmentative and alternative communication (AAC) technologies that differed in system layout and menu page approaches for 3-year-old children. Ten typically developing children were randomly assigned to each of 3 technology approaches and were asked to located vocabulary items within a play context. Results indicated that the children had difficulty with all of the technologies on initial exposure. After the 1st learning session, children performed significantly better with AAC technologies in a contextual scene format than in a grid format. Some limited generalization to new vocabulary was evident. AAC technologies for young children need to be redesigned to better reflect the developmental models of children. Results are discussed with implications for practice and suggestions for future research.

Analysis of Variance↗