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PubMed1997

Trends and differential use of assistive technology devices: United States, 1994.

OBJECTIVE: This report presents data on annual estimates of the prevalence of use of selected assistive technology devices for vision, hearing, mobility, and orthopedic impairments, including missing limbs. Also presented are statistics on trends in the prevalence of use of selected mobility assistive technology devices for the years 1980, 1990, and 1994. METHODS: The data used for this report are from the 1994 National Health Interview Survey on Disability (NHIS-D), Phase I, which was co-sponsored by a consortium of U.S. Federal agencies and private foundations. All estimates are based on data from the NHIS-D, Phase I, which represent the civilian, noninstitutional population of the United States. RESULTS: An estimated 7.4 million persons in the U.S. household population used assistive technology devices for mobility impairments, 4.6 million for orthopedic impairments (including missing limbs), 4.5 million for hearing impairments (not including impairments fully compensated by hearing aids), and 0.5 million for vision impairments. Use of any mobility device for all ages had the highest prevalence rate at 28.5 per 1,000 persons. There was a positive correlation between an increase in age and the increase in the prevalence rate of device usage; for example, of persons in the age group 65 years and over, the rate of mobility, hearing, and vision device usage was more than 4 times the rate for the total population. CONCLUSION: Assistive technology use has increased because of population size, age composition changes, and a change in the rate of use. Medical and technological advances along with public policy initiatives have also contributed to increased usage.

Adolescent↗
PubMed1985

Implications of the new technology for pharmacy education and practice.

Educators and practitioners in the health professions are faced with two questions as they attempt to adapt to changes brought by new technology. What is the nature of the technology? and What are the implications for education and practice? The present paper directs these questions to pharmacy in a three-part discussion: the implications of the technology; the relevant technology presented as brief, descriptive vignettes; and comments on the apparent problems which are created by technological change. The implications are presented first, as a set of general guidelines, second, the implications for the knowledge and skill components of education and practice, and third, as attitudes required by pharmacists and pharmacy students. The paper concludes with a list of still unanswered questions relative to the future.

Computers↗
PubMed1989

Completing the transition from clinical engineering to technology management.

Comprehensive technology management has a bright, important future in the nation's hospitals as they move into the 1990s in an environment that emphasizes high-quality, cost-effective health care. Going from equipment control to technology management will not be easy for some hospitals and some clinical engineers, but it is important to take whatever steps are necessary to accomplish the transition. The speed with which hospitals complete the transition to technology management will vary. A hospital may wish to broaden its clinical engineering department's role immediately but be realistically limited by the number of qualified personnel or the funds available. If it is not possible to accomplish them in a short time, technology management functions can be phased in. But they must not be forgotten. In many hospitals, clinical engineering has made substantial progress toward the ideal Level 5 department described in the previous article. Embracing the concept of comprehensive technology management and performing its functions will enable clinical engineering to achieve a place in the hospital that is more important and valuable than simply equipment support, and will help to prepare the hospital for the 1990s.

Biomedical Engineering↗
PubMed1982

The impact of computer-age technology on respiratory therapy.

Computer-age technology is changing the face of respiratory therapy as it is that of nearly every other technical field. In some hospital respiratory therapy departments computers are presently being used for a wide range of functions such as blood gas result reporting, billing, budgeting, purchasing, hemodynamic calculations, and respiratory monitoring. Microprocessor-controlled ventilators and respiratory monitoring systems are becoming increasingly utilized. In the future the computer may actually operate the ventilator. But who is going to operate the computer? The new breed of intensivist will be trained in critical care medicine, respiratory therapy, biomedical engineering, and computer technology. Respiratory therapists must recognize and rise to the challenge that computer-age technology presents if they are to continue as intensivists. The worst possible development of the future for respiratory therapy would be for computer-age technology to be applied to respiratory therapy without the input and inclusion of respiratory therapists. The challenge then is to be adequately prepared to utilize and apply this inevitable new computer-age technology.

Blood Gas Analysis↗
PubMedDate not supplied

Technology in nurse education: a communication teaching strategy.

This article focuses on the topic of technology in nurse education as a communication learning tool. Nurses are very interested in learning more about telehealth through the application of technology--computer-managed instruction (CMI), computer adaptive testing (CAT), computer stimulation testing (CST), telenursing, telemedicine and the Internet as it relates to improving health care delivery. With the current technology, there are many clinical implications, faculty concerns, and student issues in documentation and the explosion of knowledge and research as a direct source of information. This technology may also serve as a catalyst in bringing positive changes in the practice and the profession of nursing in collaboration with other health disciplines. Although there are limitations that cost may be a major deterrent in some schools of nursing, it is a fact that technology has invaded today's health care delivery system and the society, and is here to stay.

Communication↗
PubMed1999

Application of complementary DNA microarray technology to carcinogen identification, toxicology, and drug safety evaluation.

One major challenge facing today's cancer researchers and toxicologists is the development of new approaches for the identification of carcinogens and other environmental hazards. Here, we describe the potential impact of emerging technologies for measuring gene expression profiles on carcinogen identification and on the general field of toxicology. An example of one of these technologies is the use of cDNA microarray chips. We provide an overview to the key questions that are confronting investigators charged with determining the relative safety of natural or synthetic chemicals to which humans are exposed, followed by a discussion of how cDNA microarray technology may be applied to these questions. Gene chip technology is still a relatively new technology, and only a handful of studies have demonstrated its utility. However, as the technical hurdles to development are passed, the use of this methodology in addressing the questions raised here will be critical to increase the sensitivity of detection of the potential toxic effects of environmental chemicals and to understand their risks to humans.

Carcinogens↗
PubMed1999

Technology and the future of medical equipment maintenance.

Maintenance of medical equipment has been changing rapidly in the past few years. It is changing more rapidly in developed countries, but changes are also occurring in developing countries. Some of the changes may permit improved maintenance on the higher technology equipment in developing countries, since they do not require onsite expertise. Technology has had an increasing impact on the development of medical equipment with the increased use of microprocessors and computers. With miniaturization from space technology and electronic chip design, powerful microprocessors and computers have been built into medical equipment. The improvement in manufacturing technology has increased the quality of parts and therefore the medical equipment. This has resulted in increased mean time between failures and reduced maintenance needs. This has made equipment more reliable in remote areas and developing countries. The built-in computers and advances in software design have brought about self-diagnostics in medical equipment. The technicians now have a strong tool to be used in maintenance. One problem in this area is getting access to the self-diagnostics. Some manufacturers will not readily provide this access to the owner of the equipment. Advances in telecommunications in conjunction with self-diagnostics make available remote diagnosis and repair. Since components can no longer be repaired, a remote repair technician can instruct an operator or an on-site repairman on board replacement. In case of software problems, the remote repair technician may perform the repairs over the telephone. It is possible for the equipment to be monitored remotely by modern without interfering with the operation of the equipment. These changes in technology require the training of biomedical engineering technicians (BMETs) to change. They must have training in computers and telecommunications. Some of this training can be done with telecommunications and computers.

Equipment Failure↗
PubMedDate not supplied

The technological underpinnings of a modern clinical practice.

Information is the lifeblood of the modern clinical practice, and the information technology infrastructure is the vasculature that supports the flow of this information throughout the entire health care enterprise. Although the impact of information technology may not be obvious to the overworked clinician, information technology is the underpinning that makes virtually all knowledge-based work tenable. The increasing dependence of clinical medicine on this matrix of technologies is especially obvious when technology becomes the rate-limiting step in clinical process improvement and innovation.

Clinical Medicine↗
PubMed1999

Technological progress in ultrasonography.

Technical progress in ultrasonography (US) is especially rapid now, due to continuing advances in transducer design, signal processing techniques, and Doppler technology. A number of important technical breakthroughs have been made in the past decade. Among these, multidimensional array transducers, harmonic imaging, miniaturized transducers, extended field-of-view imaging, hand-carried ultrasound units, three-dimensional (3-D) US, and ultrasound contrast agents are the most remarkable innovations. Improved spatial and contrast resolution allows delineation of anatomic details and increases diagnostic accuracy and confidence. Miniaturized transducers can be used to image tiny or superficial structures in the human body, and can guide the surgeon to the problem site. Extended field-of-view imaging provides a larger field for demonstration of pathology in certain anatomic locations. Hand-carried US units are used widely in a physician's office or in remote areas, and bring high-quality medical imaging to the bedside. 3-D US has already shown significant benefits in perinatology; with further improvements in real-time imaging technology, 3-D US will emerge as an important adjunct to conventional 2-D US. In conjunction with harmonic imaging technology and Doppler technology, US contrast agents allow more powerful anatomic and functional evaluation of human organs. They may also play important therapeutic roles in the near future. Advancing computer technology is expected to lead to more important break-throughs in the next 5 to 10 years.

Humans↗
PubMed1999

Perfect DiViSy technology for video network in medicine (Moscow Information Network for Teleoncology).

A large telemedicine project is now under development in Moscow. The general task of the project is to link oncology research centres and hospitals meeting the project profile, and to provide on-line (using real-time video conferences) and off-line (via distributed database of medical information) information exchange. There was no existing technology available for use at the project's base which was ready to meet all requirements, so we are using specially created technology for video networks (DiViSy V.97). We suppose this technology to be more applicable for use in telemedicine networks than are business video conference technologies and classical Internet/Intranet technologies. We affirm in our conclusion that now is the time for developing special telemedicine standards, recommendations of compatibility, etc., and that we are ready to take part in this process.

Computer Communication Networks↗
PubMed1999

[Information technology in medical education].

The role of information technology in educational models of under-graduate and post-graduate medical education is growing in 1980's influenced by PC's break-in in medical practice and creating relevant data basis, and, particularly, in 1990's by integration of information technology on international level, development of international network, Internet, Telemedicin, etc. The development of new educational information technology is evident, proving that information in transfer of medical knowledge, medical informatics and communication systems represent the base of medical practice, medical education and research in medical sciences. In relation to the traditional approaches in concept, contents and techniques of medical education, new models of education in training of health professionals, using new information technology, offer a number of benefits, such as: decentralization and access to relevant data sources, collecting and updating of data, multidisciplinary approach in solving problems and effective decision-making, and affirmation of team work within medical and non-medical disciplines. Without regard to the dynamics of change and progressive reform orientation within health sector, the development of modern medical education is inevitable for all systems a in which information technology and available data basis, as a base of effective and scientifically based medical education of health care providers, give guarantees for efficient health care and improvement of health of population.

Bosnia and Herzegovina↗
PubMed2000

[Searching for evidence. A compilation of useful resources for health technology assessment].

The spectacular growth in the produced volume of published scientific and technical information during the last years makes it difficult to discriminate and localize the information of greater quality. The parallel development of technologies for the fast handling of great volumes of single information has partially solved the problem of the access and use of the most advisable information. Health technology assessment tries to facilitate the decision making on the introduction, diffusion or use of health technologies, being based on the best evidences available. In order to improve the process of searching for evidences, needed in the process of health technology assessment, the Agency of Health Technology Assessment of the Institute of Salud Carlos III (AETS) made a compilation of information resources that can be useful for searching biomedical information in general. This article presents the above mentioned compilation along with the description of the process of elaboration and the criteria of selection applied.

Databases as Topic↗
PubMed2000

Managing the learning and work of new information technology users.

The information technology revolution has transformed work from modest-paced serial processes to complex, fast-paced networked ones that depend not only on the technology but also on skilled and effective users of the technology. This evolution has woven a complex quilt of interdependencies among new information technologies, new users of those technologies, new skills required, new information management policies and procedures, and new opportunities. We must impose a new structure for managing the learning and work of new users, their tolerance of complexity and continuous learning, value-added usability, minimization of human error, and new support services for deployment, administration, and help.

Computer User Training↗
PubMed2000

Clinical and cost implications of new technologies for cervical cancer screening: the impact of test sensitivity.

OBJECTIVE: To compare the available techniques for cervical cancer screening, including several new technologies, using actual program utilization patterns. STUDY DESIGN: Longitudinal cohort model. PATIENTS AND METHODS: The model followed a cohort of 100,000 women who underwent screening from age 20 through 65 years. The model was run with a weighted average of screening intervals to model the actual utilization of the cervical cancer screening program in the United States. RESULTS: The model demonstrated that new technologies with significantly increased test sensitivity have the potential to reduce the number of cancers by 45% to 60% depending on the screening frequency in fully compliant populations. At screening intervals of 2 years or more, these new technologies had cost-effectiveness ratios below $50,000 per life-year saved. Assuming existing utilization patterns, the model predicted there would be 13.2 cancers per year in the 100,000 women screened with the conventional Pap smear, and new technologies with increased test sensitivity could reduce the annual incidence to 9.5 cancers per 100,000 women screened. CONCLUSIONS: The model suggests that to achieve further dramatic reduction in cervical cancer mortality, significant improvements in test sensitivity, as reflected in the new screening technologies, may be the most realistic and cost-effective approach.

Adolescent↗
PubMedDate not supplied

[Resources-technologies relationship in public health].

Analysis of the resources-technologies relationships brought the authors to two underlying conclusions: 1) a practical public health system is primarily a system of technological equipment and sufficient staff. A liberal public health system is primarily a system of medical and concomitant technologies based on the requirements of patients. 2) Management of a practical public health system is priority management of the form, namely, technological basis and staff members, or in fact administrative distribution of resources. Regulation of the activities of a liberal public health system is the priority modification of its content, i.e., creation and adaptation of technologies determining this system (including medical) evoked by certain requirements and largely by the market.

Humans↗
PubMedDate not supplied

Changing how and what children learn in school with computer-based technologies.

Schools today face ever-increasing demands in their attempts to ensure that students are well equipped to enter the workforce and navigate a complex world. Research indicates that computer technology can help support learning, and that it is especially useful in developing the higher-order skills of critical thinking, analysis, and scientific inquiry. But the mere presence of computers in the classroom does not ensure their effective use. Some computer applications have been shown to be more successful than others, and many factors influence how well even the most promising applications are implemented. This article explores the various ways computer technology can be used to improve how and what children learn in the classroom. Several examples of computer-based applications are highlighted to illustrate ways technology can enhance how children learn by supporting four fundamental characteristics of learning: (1) active engagement, (2) participation in groups, (3) frequent interaction and feedback, and (4) connections to real-world contexts. Additional examples illustrate ways technology can expand what children learn by helping them to understand core concepts in subjects like math, science, and literacy. Research indicates, however, that the use of technology as an effective learning tool is more likely to take place when embedded in a broader education reform movement that includes improvements in teacher training, curriculum, student assessment, and a school's capacity for change. To help inform decisions about the future role of computers in the classroom, the authors conclude that further research is needed to identify the uses that most effectively support learning and the conditions required for successful implementation.

Adolescent↗
PubMed2001

Preparation of drug delivery systems using supercritical fluid technology.

Small changes in temperature and pressure near the critical region induce dramatic changes in the density and solubility of supercritical fluids, thereby facilitating the use of environmentally benign agents such as CO2 for their solvent and antisolvent properties in processing a wide variety of materials. While supercritical fluid technologies have been in commercial use in the food and chromatography industries for several years, only recently has this technology made inroads in the formulation of drug delivery systems. This review summarizes some of the recent applications of supercritical fluid technology in the preparation of drug delivery systems. Drugs containing polymeric particles, plain drug particles, solute-containing liposomes, and inclusion complexes of drug and carrier have been formulated using this technology. Also, polymer separation using this technology is enabling the selection of a pure fraction of a polymer, thereby allowing a more precise control of drug release from polymeric delivery systems.

Drug Delivery Systems↗
PubMed2001

[Is autologous chondrocyte implantation a technology suitable for ambulatory health care?].

Statutory ambulatory health care services provided by physicians in Germany are specified by a joint committee of physicians and sickness funds, the Federal Committee of Physicians and Sickness Funds. To ensure that only effective interventions are covered, new medical technologies must demonstrate evidence of clinical effectiveness, cost-effectiveness and medical necessity. Due to increasing demands for reimbursement of autologous chondrocyte implantation, the Committee recently assessed this procedure. Autologous chondrocyte implantation (ACI) is a surgical procedure to reestablish the chondral layer in the knee following trauma. Such injuries may subsequently lead to osteoarthritis, and may eventually require joint replacement. Although the U.S. Food and Drug Administration (FDA) approval of ACI limits its usage to treatment of specific knee defects, other indications, such as for chondromalacia patellae, are promoted by proponents of the technology. The Committee conducted a thorough literature review and examined the status of ACI in other health care systems. Reimbursement of this technology was declined for the following reasons: the effectiveness of ACI has not yet been established in long term, comparative studies, and the procedure involves a type of operation not suitable for the ambulatory health care sector. Other public health insurance systems, such as in Switzerland and Canada, have not yet introduced funding for ACI, and an assessment is currently being conducted by the UK National Institute for Clinical Excellence (NICE). Autologous chondrocyte implantation is a technology that will compete with various other new interventions to correct chondral defects of the knee. It is essential that the treatment effect of ACI be demonstrated in clinically sound, comparative trials before this technology is introduced into the public health care system.

Ambulatory Care↗