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PubMed2001

Ethnographic critique and technoscientific narratives: the old mole, ethical plateaux, and the governance of emergent biosocial polities.

A reading of the puzzle novel Vienna Blood, by Adrian Mathews, is juxtaposed to three ethnographic sketches of contemporary ethical plateaus or domains of ethical challenge--the challenges of informed public consent to new technologies, the seductions to do whatever is medically possible (sometimes at the expense of quality of life or the good death'). and the power of money in driving the biotechnological industries. Vienna Blood deals with precautionary germplasm modification and chemical camouflage justified as protection against ethnically-targeted biological warfare, and touches on a series of technologies such as new reproductive technologies, genetic engineering, and cryptographic attacks and defenses, as well as the ability to evade regulatory controls. Such technoscientifically informed novels are useful as cautionary tales, in exploring the complexity and interaction among new technologies, and the phantasmagoria that help drive new technologies. They are not so good at thinking through institutional development: a challenge for ethnography and new social theory. Ethnography, like novels, can function as checks on the mechanisms of abstraction and universalization that frequently bedevil the non-anthropological, non-cross-culturally or cross-temporally comparative, social sciences. Questions are raised about new or emergent biosocialities, forms of governance, and forms of cultural critique.

Advertising↗
PubMed2002

Defining the future of health technology: biomechatronics.

Future progress in healthcare and medicine depends on today's investment in research, development, and education. We cannot leave such urgent issues to determine themselves, but rather must actively collaborate to ensure a stable healthcare system. This chapter describes efforts made by leading experts in industry, government, and academia to better ascertain future healthcare management. Such collaboration has occurred during a series of Future Healthcare Technology Summits helping in planning investments in health technology. Deliberating and reviewing plans before taking action will accelerate progress as it will (1) save costs, (2) encourage compliance, (3) improve clinical outcomes, and (4) ensure greater patient satisfaction. What we must resolve is: How can we invest a couple billion dollars to save hundreds of billions and, most importantly, increase human health in the future. A new branch of science, Biomechatronics, with millions of Intelligent Caring Creatures- is the answer.

Artificial Intelligence↗
PubMed1999

Technical aspects of neonatal screening using tandem mass spectrometry. Report from the 4th meeting of the International Society for Neonatal Screening.

Quantitative analysis of amino acids (AA) and acylcarnitines using tandem mass spectrometry is an emerging technology used to screen neonatal dried blood spot samples for disorders in the metabolism of AA, organic acids and fatty acids. This paper provides a brief review of some of the technically oriented issues which emerged at the 4th meeting of the International Society for Neonatal Screening in Stockholm, 1999. The information covers sample preparation, instrumentation, data acquistion modes, internal standards, interpretation, confounding factors and practical screening experience.

Amino Acid Metabolism, Inborn Errors↗
PubMed2003

Shrinking the biologic world--nanobiotechnologies for toxicology.

Although toxicologic effects need to be considered at the organismal level, the adverse events originate from interactions and alterations at the molecular level. Cellular structures and functions can be disrupted by modifications of the nanometer structure of critical molecules; therefore, devices used to assess biologic and toxicologic processes at the nanoscale will allow important new research pursuits. In order to properly assess alterations at these dimensions, nanofabricated tools are needed to detect, separate, analyze, and manipulate cells or biologic molecules of interest. The emergence of laser tweezers, surface plasmon resonance (SPR), laser capture microdissection (LCM), atomic force microscopy (AFM), and multi-photon microscopes have allowed for these assessments. Micro- and nanobiotechnologies will further advance biologic, clinical, and toxicologic endeavors with the aid of miniaturized, more sensitive devices. Miniaturized table-top laboratory equipment incorporating additional innovative technologies can lead to new advances, including micro total analysis systems (microTAS) or "lab-on-a-chip" and "sentinel sensor" devices. This review will highlight several devices, which have been made possible by techniques originating in the microelectronics industry. These devices can be used for toxicologic assessment of cellular structures and functions, such as cellular adhesion, signal transduction, motility, deformability, metabolism, and secretion.

Animals↗
PubMed2005

Bioimpedance and p-Health.

Bio-impedance is the electrical impedance of living matter. Bio-impedance methods present a range of known advantages for medical and clinical applications including low-cost, non-invasiveness and harmlessness. The measured parameter reflects the physiological and pathological processes that take place within human body. The technological progress in instrumentation has significantly contributed to the progress that has been observed during the last past decades in impedance spectroscopy and electrical impedance tomography. Although bioimpedance is not a physiological parameter, the method enables tissue characterisation and functional monitoring and can contribute to the monitoring of the health status of a person. The association of this flexible and versatile method with micro-electronics and wireless telecommunication systems opens a new field of potential applications.

Biomedical Technology↗
PubMed2005

Health-care decision-making processes in Latin America: problems and prospects for the use of economic evaluation.

OBJECTIVES: The use of economic evaluation studies (EE) in the decision-making process within the health-care system of nine Latin American (LA) and three European countries was investigated. The aim was to identify the opportunities, obstacles, and changes needed to facilitate the introduction of EE as a formal tool in health-care decision-making processes in LA. METHODS: A comparative study was conducted based on existing literature and information provided through a questionnaire applied to decision makers in Argentina, Brazil, Colombia, Cuba, Mexico, Nicaragua, Peru, Portugal Spain, United Kingdom, Uruguay, and Venezuela. Systematic electronic searches of HEED, NHS EED, and LILACS were conducted to identify published economic evaluation studies in LA from 1982 onward. RESULTS: There is relatively little evidence of the conduct and use of EE within the health care systems in LA. Electronic searches retrieved 554 records; however, only 93 were EE. In the nine LA participating countries, broad allocation of health-care resources is primarily based on political criteria, historical records, geographical areas, and specific groups of patients and diseases. Public-health provision and inclusion of services in health-insurance package are responsibilities of the Ministry of Health. Decisions regarding the purchase of medicines are primarily made through public tenders, and mainly based on differences in clinical efficacy and the price of health technologies of interest. CONCLUSIONS: To expedite the process of incorporating EE as a formal tool to inform decision-making processes within the health-care systems in LA countries, two main conditions need to be fulfilled. First, adequate resources and skills need to be available to conduct EE of good quality. Second, decision-making procedures need to be modified to accommodate "evidence-based" approaches such as EE.

Biomedical Technology↗
PubMed2004

Free the dinosaurs into butterfly gardens: in a search for changing the profile of the academic professional.

In the present debate about academic medicine in crisis, I argue that the problem is partly the consequence of a global process of alienation and depersonalization. Technology-based medicine is one of the key players which creates unsuitable role models. In its wake and as a consequence, the profile of the academic professional must be redesigned. Academic professionals should influence more strongly not only the quality of health care but the whole mentality in our socialized world. Academia itself should also become an arena for advanced ideas, and creative power pervaded by the humanities -- a facet which has been lost.

Academic Medical Centers↗
PubMed2000

Expert and non-expert knowledge in medical practice.

One problematic aspect of the rationality of medical practice concerns the relation between expert knowledge and non-expert knowledge. In medical practice it is important to match medical knowledge with the self-knowledge of the individual patient. This paper tries to study the problem of such matching by describing a model for technological paradigms and comparing it with an ideal of technological rationality. The professionalised experts tend to base their decisions and actions mostly on medical knowledge while the rationality of medicine also involves just as important elements of the personal evaluation and knowledge of the patients. Since both types of knowledge are necessary for rational decisions, the gap between the expert and the non-expert has to be bridged in some way. A solution to the problem is suggested in terms of pluralism, with the patient as ultimate decision-maker.

Biomedical Technology↗
PubMed2006

Funding technology: evaluating and exercising the leasing option.

Tax-exempt capital leases, when structured through the appropriate conduit authority, are an excellent option for financing equipment that the hospital wants to own. Operating leases offer the benefits of immediate cash flow savings when compared with buying equipment, fewer complications and lower upfront costs when compared with bond issues, and the ability to match short-term assets with short-term liabilities. A best-practice leasing process involves nine steps progressing from assessing needs and soliciting bids from equipment manufacturers to implementing the lease and providing continuing disclosure.

Benchmarking↗
PubMed2006

The making of health:: a reflection on the first 10 years in the life of a journal.

This introduction to the Tenth Anniversary Issue surveys articles that have been published in health: since its launch. Reviewing the original aims of the journal, the editors discuss some of the main issues that authors have raised, both about health and illness. Focusing upon articles that have been published in this particular journal, we discuss the way that new medical technologies--particularly global ones--have shaped ideas about disease and its treatment, and in consequence about what 'good health' should be. Related to the growth in medical and other technology--not least the rise of the Internet during the life of this journal--is the number of articles that discuss the rights of patients and the establishment of what might be termed an 'illness culture'. We conclude that there continues to be more to health than it being the background to illness or disease, and ask the question: should the 'taken for grantedness' of health be taken for granted any longer?

Anniversaries and Special Events↗
PubMed2002

Prehospital evaluation and care of the special needs and technology-dependent child.

As EMS providers, most of you will care for a child with a special healthcare need at some point in your career. The complexity of these patients and the vast array of specialized equipment required for their medical care, however, need not be frightening. Most of the care these children require will fall within your scope of practice. A rapid assessment using the ABC approach and timely transport to the hospital will be sufficient in the majority of cases. Remember, the child's care provider is a valuable resource and should be used to the fullest extent whenever possible.

Adolescent↗