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PubMed2001

Technology-dependent children in the community: definitions, numbers and costs.

OBJECTIVES: To assess available data on the numbers of technology-dependent children living at home in the UK and estimate the costs of caring for them. DESIGN: Data were obtained from all known secondary sources, including surveys of children with specific conditions known to specialist paediatric departments and the database of applicants to the Family Fund Trust. The costs of all services received by three hypothetical exemplar 'case study' children were calculated. RESULTS: All existing sources of data have some shortcomings. Taking these shortcomings into account, it is estimated that there may be up to 6000 technology-dependent children living at home. They appear to be disproportionately young and may be distributed unevenly between different regions of the UK. The total service costs of caring for each child will vary according to the types of technologies involved and local patterns of services, but may be as high as 150,000 pounds sterling a year. CONCLUSIONS: Because of the very high costs of services, routine information on the numbers of technology-dependent children discharged home is urgently needed. This should include details of the duration of technology dependence and the local area to which the child is discharged. New opportunities for joint service planning and purchasing should improve the co-ordination of services for these children.

Adolescent↗

PubMed1995

Technology and the lifeworld of critical care nursing.

Traditionally, nursing scholars have concerned themselves with philosophies of science. This perspective reflects the Platonic dominance of theory over practice. The consequence of this view is that technology is conceived as an applied science. Furthermore, technology is considered as a neutral instrument of science. The primacy of theory was challenged by the philosopher Martin Heidegger, who argued that the correct relationship between these two concepts was a technology-science one. This reconceptualization suggests that practice precedes theory. This paper examines the developing body of literature concerning the philosophy of technology. Specifically, the philosophies of Martin Heidegger, Don Ihde, Albert Borgmann and Langdon Winner are explored from a nursing perspective, and how they may offer nursing a way of conceptualizing the ever expanding technological environment of the intensive care unit is discussed.

Critical Care↗

PubMed2004

Technology-dependent children and their families: a review.

BACKGROUND: Advances in medical technology and nursing care have enabled children who rely on long-term medical and technical support to reunite with their families and community. The impact of discharging these children into the community involves a number of unprecedented social implications that warrant policy consideration. To begin with, an effort must be made to understand the phenomenon of caring for technology-dependent children living at home. AIM: The aim of this paper is to provide a comprehensive literature review on caring for technology-dependent children living at home. METHODS: The review was conducted via keyword searches using various electronic databases. These included CINAHL, MEDLINE, Social Science Index, Sociological Abstracts, Australian Family and Society Abstracts, and the Australian Bureau of Statistics. The articles and books found were examined for commonality and difference, significant themes were extracted, and the strength of the research methods and subsequent evidence were critiqued. FINDINGS: In this paper, themes relating to home care for technology-dependent children and their families are elucidated and summarized. These are: chronic illness and children; the impact of paediatric home care on children; the uniqueness of technology-dependent children and their families; and parents' experience of paediatric home care. DISCUSSION: Contentious issues, relevant to the social life of these children and their families, are raised and are discussed with the intention of extending awareness and provoking further debate among key stakeholders. These issues include: the changed meaning of home; family dynamics; social isolation; saving costs for whom?; shifts in responsibility; and parent-professional relationships. CONCLUSION: More research is needed in the arena of paediatric home care, to facilitate relevant policy formation and implementation.

Attitude to Health↗

PubMed2003

Understanding and motivating health care employees: integrating Maslow's hierarchy of needs, training and technology.

AIM: This paper applies Maslow's Hierarchy of Needs Model to the challenges of understanding and motivating employees in a rapidly changing health care industry. BACKGROUND: The perspective that Maslow's Model brings is an essential element that should be considered as the health care arena is faced with reorganization, re-engineering, mergers, acquisitions, increases in learning demands, and the escalating role of technology in training. EVALUATION: This paper offers a new perspective related to how Maslow's Model, as used in business/organizational settings, can be directly related to current workforce concerns: the need for security and freedom from stress, social belongingness, self-esteem, self-actualization, altered work/social environments, and new opportunities for learning and self-definition. KEY ISSUES: Changes in health care will continue at an accelerated pace and with these changes will come the need for more and more training. The use of technology in training has heightened access, faster distribution, innovation and increased collaboration. However, with this technology come attendant challenges including keeping up with the technology, the increased pace of training, depersonalization, and fear of the unknown. The Maslow model provides a means for understanding these challenges in terms of universal individual needs. CONCLUSION: How does one motivate employees in the face of increased demands, particularly when they are being asked to meet these demands with fewer resources? The answer is, in large part, to make the employee feel secure, needed, and appreciated. This is not at all easy, but if leaders take into consideration the needs of the individual, the new technology that provides challenges and opportunities for meeting those needs, and provides the training to meet both sets of needs, enhanced employee motivation and commitment is possible.

Attitude of Health Personnel↗

PubMed1999

Mr Lewis on the Web--how to convert learning resources for intranet technology.

OBJECTIVES: Intranet technology is the application of Internet tools in local networks. Due to the diversification of hardware and the need for international cooperation, cross-platform systems with network access are required for computer-based training (CBT). The latest advances in Web technology make it feasible to have interactive CBT on the Web: Web-based training (WBT). It is possible to convert existing interactive learning programs to Intranet technology. This approach combines the evaluated contents of excellent learning resources with the technical advantages of Web technology. DESIGN: 'Mr Lewis' is a case about pulmonary embolism, developed by Harold Sox, M.D., working with one of the authors, and peer-reviewed at Dartmouth Medical School (DMS), where it is now being used in the third-year clerkship in Internal Medicine as one of several CBT programs assigned to students in the clerkship. RESULTS: The process and the tools necessary to convert an interactive learning program to Intranet technology are described. CONCLUSIONS: International cooperation for CBT development is much more effective with this technique than with conventional platform-dependent stand-alone software. Web-based training can play an important role in the education of medical students and doctors.

Clinical Clerkship↗

PubMed2002

Marrying modern health practices and technology with traditional practices: issues for the African continent.

One of the main sessions at the 2001 22nd Quadrennial Congress of the International Council of Nurses in Denmark explored the harnessing of modern health technologies for contemporary health care. The session theme of 'marrying the old and the new' is particularly important in societies where modern medicine and technology coexist with traditional approaches to health care; in this instance, its coexistence with traditional medicine in African societies. This coexistence has not been easy for many African countries. For some, overt exclusion from health care systems through prohibitive legislation has become the order of the day for traditional practitioners. On the other hand, there has been an increasing interest in traditional practices among modern health practitioners and a willingness to collaborate. Similarly, traditional practitioners are slowly beginning to incorporate aspects of modern medicine into their practice; notably the use of science and technology. This report describes the interface of modern medicine and technologies with traditional approaches to health care. Benefits and concerns raised by genetic, information, solar and environmental technologies at this interface, are discussed. Selected traditions and the challenges these bring to the practice arena, research, education and policy, are presented together with suggestions to reconcile old and new.

Africa↗

PubMed2004

The future of computing--new architectures and new technologies.

All modern computers are designed using the 'von Neumann' architecture and built using silicon transistor technology. Both architecture and technology have been remarkably successful. Yet there are a range of problems for which this conventional architecture is not particularly well adapted, and new architectures are being proposed to solve these problems, in particular based on insight from nature. Transistor technology has enjoyed 50 years of continuing progress. However, the laws of physics dictate that within a relatively short time period this progress will come to an end. New technologies, based on molecular and biological sciences as well as quantum physics, are vying to replace silicon, or at least coexist with it and extend its capability. The paper describes these novel architectures and technologies, places them in the context of the kinds of problems they might help to solve, and predicts their possible manner and time of adoption. Finally it describes some key questions and research problems associated with their use.

Journal Article↗

PubMed1999

The role of top management in supporting the use of information technology in Australian hospitals.

The progressive use of information systems and information technology has the potential to transform the way complex organisations are managed and the way they operate. This article reports the findings of a study undertaken to examine the importance of various factors related to the progressive use of information technology in Australian hospitals. Our analysis of data from 84 hospitals shows that hospital size has a significant positive relationship with the progressive use of information technology, as does the chief executive officer's attitude to information technology; however chief executive officer participation in information technology activities does not. The implications of these findings for the role of top management are discussed.

Attitude of Health Personnel↗

PubMed1995

A perspective on early commercial applications of voice-processing technology for telecommunications and aids for the handicapped.

The Colloquium on Human-Machine Communication by Voice highlighted the global technical community's focus on the problems and promise of voice-processing technology, particularly, speech recognition and speech synthesis. Clearly, there are many areas in both the research and development of these technologies that can be advanced significantly. However, it is also true that there are many applications of these technologies that are capable of commercialization now. Early successful commercialization of new technology is vital to ensure continuing interest in its development. This paper addresses efforts to commercialize speech technologies in two markets: telecommunications and aids for the handicapped.

Activities of Daily Living↗

PubMed2005

Profiling of alopecia areata autoantigens based on protein microarray technology.

Protein biochips have a great potential in future parallel processing of complex samples as a research tool and in diagnostics. For the generation of protein biochips, highly automated technologies have been developed for cDNA expression library production, high throughput protein expression, large scale analysis of proteins, and protein microarray generation. Using this technology, we present here a strategy to identify potential autoantigens involved in the pathogenesis of alopecia areata, an often chronic disease leading to the rapid loss of scalp hair. Only little is known about the putative autoantigen(s) involved in this process. By combining protein microarray technology with the use of large cDNA expression libraries, we profiled the autoantibody repertoire of sera from alopecia areata patients against a human protein array consisting of 37,200 redundant, recombinant human proteins. The data sets obtained from incubations with patient sera were compared with control sera from clinically healthy persons and to background incubations with anti-human IgG antibodies. From these results, a smaller protein subset was generated and subjected to qualitative and quantitative validation on highly sensitive protein microarrays to identify novel alopecia areata-associated autoantigens. Eight autoantigens were identified by protein chip technology and were successfully confirmed by Western blot analysis. These autoantigens were arrayed on protein microarrays to generate a disease-associated protein chip. To confirm the specificity of the results obtained, sera from patients with psoriasis or hand and foot eczema as well as skin allergy were additionally examined on the disease-associated protein chip. By using alopecia areata as a model for an autoimmune disease, our investigations show that the protein microarray technology has potential for the identification and evaluation of autoantigens as well as in diagnosis such as to differentiate alopecia areata from other skin diseases.

Adult↗

PubMed2006

Expanding the subproteome of the inner mitochondria using protein separation technologies: one- and two-dimensional liquid chromatography and two-dimensional gel electrophoresis.

Currently no single proteomics technology has sufficient analytical power to allow for the detection of an entire proteome of an organelle, cell, or tissue. One approach that can be used to expand proteome coverage is the use of multiple separation technologies especially if there is minimal overlap in the proteins observed by the different methods. Using the inner mitochondrial membrane subproteome as a model proteome, we compared for the first time the ability of three protein separation methods (two-dimensional liquid chromatography using the ProteomeLab PF 2D Protein Fractionation System from Beckman Coulter, one-dimensional reversed phase high performance liquid chromatography, and two-dimensional gel electrophoresis) to determine the relative overlap in protein separation for these technologies. Data from these different methods indicated that a strikingly low number of proteins overlapped with less than 24% of proteins common between any two technologies and only 7% common among all three methods. Utilizing the three technologies allowed the creation of a composite database totaling 348 non-redundant proteins. 82% of these proteins had not been observed previously in proteomics studies of this subproteome, whereas 44% had not been identified in proteomics studies of intact mitochondria. Each protein separation method was found to successfully resolve a unique subset of proteins with the liquid chromatography methods being more suited for the analysis of transmembrane domain proteins and novel protein discovery. We also demonstrated that both the one- and two-dimensional LC allowed for the separation of the alpha-subunit of F1F0 ATP synthase that differed due to a change in pI or hydrophobicity.

Animals↗

PubMed2000

The effects of multimedia communication technology on non-collocated teams: a case study.

Collaborative teams are becoming increasingly important for industry, both within and across companies. There is a need for communication technology to support teams because many teams are non-collocated, or 'virtual'. Two automotive supply chain teams were observed while they were experimenting with multimedia conferencing in order to determine what support non-collocated teams need and the potential effects of introducing technologies on their group processes. The observations included meeting recordings and other sources that show the organizational factors affecting teams. Working in teams requires very close collaboration. Communication technology can help teams if it is used to foster close and relatively informal person-to-person interaction. Organizational constraints on how the technology is introduced favour high-technology, special-purpose installations, but teams can best be supported using relatively modest equipment with desktop access.

Ergonomics↗

PubMed1994

Technology and older adults: factors affecting the adoption of automatic teller machines.

Although technology can benefit service providers, caregivers, and the elderly, its application in an aging society can bring special challenges. This study looked at older adults' adoption of one technology that is highly prevalent in modern society--the automatic teller machine (ATM). The findings indicated that users and nonusers differed in mechanical reasoning skills and in attitudes toward ATM technology. Older adults with higher mechanical reasoning skills were more likely to be ATM users. Nonusers had more negative attitudes toward ATMs, and, among nonusers, those who had tried an ATM had more positive attitudes than those who had never tried one. The findings of this study are discussed in terms of factors that may affect the adoption of other technologies by older adults. Suggestions for increasing the acceptance of technologies by the elderly are also addressed.

Aged↗

PubMedDate not supplied

Biomarkers of cancer risk and therapeutic benefit: new technologies, new opportunities, and some challenges.

The biotechnology revolution offers unprecedented opportunities for identification of mechanistically-based biomarkers that report and predict cancer and other pathologies. The combination of genomic technologies with a knowledge of gene sequence and sequence conservation has made available markers that facilitate the correlation of genetic variation with biological outcomes, and "-omic" technologies allow efficient biochemical characterization of functional pathways--providing new markers of the susceptibility of individuals to cancer development, and of tumor susceptibility to specific therapies. New therapeutic agents targeted to individuals with specific genetic or biochemical characteristics already exist. The powerful -omic technologies allow efficient monitoring of gene transcripts, proteins, and intermediary metabolites, making it possible to monitor a large number of key cellular pathways simultaneously. This has enabled the identification of key biomarkers and signaling molecules associated with cell growth, cell death, and cellular metabolism. These new markers are facilitating monitoring of functional disturbance, molecular and cellular damage, and damage-response. Improved imaging technologies have made it feasible to image some of these molecular events noninvasively. To meet the challenge of evaluating and developing consensus criteria for the application of these new technologies and biomarkers, consortium approaches are being increasingly undertaken to share resources and to build a common understanding among the research, industry, and regulatory communities. These developments promise more efficient pharmaceutical product development, safer and more efficacious drugs, and provide clinical practitioners with new and better biomarkers for cancer screening, patient monitoring, and choice of therapy.

Animals↗

PubMed2005

Assessing the benefits of using assistive technologies and other supports for thinking, remembering and learning.

PURPOSE: Planning assistive technologies and other supports for individuals with cognitive disabilities requires a comprehensive and individualized assessment of current goals, past experiences with the use of technologies and other supports, and the person's predisposition to the use of alternative or additional supports. This paper discusses a foundation for the refinement of an existing assessment process to match technologies to individuals with cognitive disabilities. METHOD: Prior research and a literature review identified the critical needs for an assessment process that would serve to identify key elements known to influence the success use of assistive technology and other supports by persons with cognitive disabilities. RESULTS: The components of successful, effective and satisfied support use result from a good match of device and support features, user goals and preferences, and environmental resources. The relationship to the World Health Organization's International Classification of Functioning, Disability and Health and the International Standardization Organization's international standard ISO DIS 9999 is discussed. CONCLUSIONS: As the number of assistive technology options increase, individualized interventions for individuals with cognitive disabilities will be easier to accomplish. The key to successful and optimal use of these products will be an appropriate and comprehensive assessment of consumer needs and preferences and the identification of additional accommodations and supports.

Cognition↗

PubMed1996

Development of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST).

This study's purpose was to develop a clinical instrument designed to evaluate user satisfaction with assistive technology devices. This paper describes the methodology used to develop the instrument entitled the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST). Based on the theoretical and practical foundations of assistive technology as well as on the concept of satisfaction, preliminary versions of the instrument were created and examined by a panel of team participants. After the panel's recommendations were incorporated, a pretest of the revised instrument was conducted and the final French version of QUEST emerged. The originality of QUEST lies in its inter-activeness and user-directed approach to assessing satisfaction with assistive technology. From a set of 27 variables, the user is asked to indicate the degree of importance he/she attributes to each of the satisfaction variables and then to rate his/her degree of satisfaction with each of the variables considered (quite or very) important. While QUEST remains a clinical instrument undergoing pilot testing, it holds much promise in our quest for a reliable and valid means of assessing assistive technology outcome from the user's perspective.

Humans↗

PubMed2000

Item analysis of the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST).

The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) is an outcomes assessment tool designed to measure satisfaction with assistive technology in a structured and standardized way. The purpose of this article is to present the results of an analysis of the 24 items comprising QUEST and to explain how a subset of items demonstrating optimal measurement performance was selected. The criteria against which the items were measured were general acceptability, content validity, contribution to internal consistency, test-retest stability, and sensitivity. The items that ranked best in terms of these measurement properties were submitted to factorial analysis in order to complete the item selection. The first series of analyses reduced the item pool approximately by half, and the second series of analyses led to the final selection of 12 items. Factor analysis results suggested a bidimensional structure of satisfaction with assistive technology related to the assistive technology device (eight items) and services (four items). The 12-item revised version that will result from this study should prove to be a reliable and valid instrument for measuring outcomes in the field of assistive technology.

Consumer Behavior↗

PubMed2005

High-throughput screening using beta-lactamase reporter-gene technology for identification of low-molecular-weight antagonists of the human gonadotropin releasing hormone receptor.

G-protein coupled receptors (GPCRs) signal via G-proteins to intracellular second messengers. Assays that link transcription of a detectable reporter to promoters that are activated by such signaling cascades are highly sensitive and allow screening for compounds that either activate or inactivate a GPCR of interest. This study describes the development and performance of an antagonistic screen on the human gonadotropin releasing hormone receptor (GnRH-R). Compounds (245,000) were tested in a high-throughput screen using a Chinese hamster ovary cell line stably expressing the human GnRH-R and the Ca2+ sensitive reporter nuclear factor activated in T-cells/ activator protein-1-beta-lactamase. In total, 4,160 active compounds were identified. Colored and toxic compounds, as well as dust and compound aggregates, have been depicted as artifacts. To deselect non-target hits, several follow-up assays, including luminescent and fluorescent Ca2+ mobilization assays and radioligand binding, were developed for the GnRH-R. These assays were validated using peptide and low-molecular-weight GnRH-R reference compounds before hits from screening were also profiled in these assays. For several reference compounds the use of different assay technologies resulted in a poor correlation of potency values. In conclusion, beta-lactamase as a primary high-throughput screening assay is a powerful complementation to other screening technologies. The beta-lactamase technology has several advantages, including lack of cell lysis and ratiometric read-out, which augments assay robustness. Based on technology comparison, it is not adequate to assume that the same hits would be found regardless of which assay technology is used.

Animals↗