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At least 1,315 records · Page 73Linked to original sources
PubMed2004

Biomedical informatics: development of a comprehensive data warehouse for clinical and genomic breast cancer research.

The Windber Research Institute is an integrated high-throughput research center employing clinical, genomic and proteomic platforms to produce terabyte levels of data. We use biomedical informatics technologies to integrate all of these operations. This report includes information on a multi-year, multi-phase hybrid data warehouse project currently under development in the Institute. The purpose of the warehouse is to host the terabyte-level of internal experimentally generated data as well as data from public sources. We have previously reported on the phase I development, which integrated limited internal data sources and selected public databases. Currently, we are completing phase II development, which integrates our internal automated data sources and develops visualization tools to query across these data types. This paper summarizes our clinical and experimental operations, the data warehouse development, and the challenges we have faced. In phase III we plan to federate additional manual internal and public data sources and then to develop and adapt more data analysis and mining tools. We expect that the final implementation of the data warehouse will greatly facilitate biomedical informatics research.

Breast Neoplasms↗
PubMed2006

Stopping nutrition and hydration technologies: a conflict between traditional Catholic ethics and church authority.

This article focuses on the troubling effects of the secular values of individual freedom and autonomy and their impact on laws regarding suicide and euthanasia. The author argues that in an increasingly secularized culture, death and dying are losing their meaning and are not thought of within a moral framework. The debate regarding the provision of artificial nutrition and hydration is critically considered in light of the history of Catholic morality as well as within the modern healthcare context, and finally with new insight from the recent statements made by the late pope. Drane argues that the pope's insistence on providing artificial nutrition and hydration despite irreversible persistent vegetative states in unconvincing.

Alzheimer Disease↗
PubMed2002

Relationship between technological influences and caring attributes of Korean nurses.

With many well-prepared nurse academics, a buoyant economy and an advanced health-care system, it is timely that research addresses some of the features and characteristics of Korean nurses and communicates this to the English-speaking world. This study focuses on Korean registered nurses and their views of themselves as carers in a modern technological environment. By collecting data from a sample of 560 registered nurses and using an instrument previously administered in an international sample, comparisons to normative data are presented and contrasted to recent reports. The instrument uses Likert items to measure caring attributes and technological influences. The results show that older, more experienced and more qualified Korean nurses tend to report significantly higher scores for caring attributes, yet approximately 80% of the sample were aged less than 30, 70% were unmarried, 70% had less than 6 years experience and 60% were diploma prepared. These results are discussed in the light of normative findings from the international study and, in the context of this unique homogeneous cultural sample, concern is expressed about the lack of senior role models and the apparent drain of senior professionals.

Adult↗
PubMed2006

Glaucoma screening: current trends, economic issues, technology, and challenges.

PURPOSE OF REVIEW: Glaucoma is one of the leading causes of irreversible blindness worldwide. Early glaucoma detection and treatment are currently the only known methods for preventing blindness and low vision resulting from this frequently asymptomatic disease. RECENT FINDINGS: New technologies for detecting early glaucomatous damage are important in diagnosing optic nerve disease, not only in community screening settings but also in clinics. Imaging of the optic nerve head and macula and retinal nerve fiber layer analysis can provide quick, automated, and quantitative measurements in agreement with clinical estimates of optic disc structure and visual function. In the area of perimetry, frequency-doubling technology is a promising and feasible mass-screening method with reasonable sensitivity for detecting visual field loss. Central corneal thickness has emerged as a new risk factor for the development and progression of glaucoma, thereby complicating the role of tonometry and measurement of intraocular pressure as screening parameters for glaucoma. Along with technological advances, strides are also being made with public policy and legislative efforts to bring glaucoma onto the national and global health care agenda. These initiatives incorporate vision-screening goals into national disease prevention programs emphasizing the need for early glaucoma detection and treatment. SUMMARY: Glaucoma awareness needs to be increased through better education, and compliance with follow-up care needs to be improved to decrease the economic and social costs from glaucoma. In addition, screening models need to be developed that will be effective in developing countries where the risk of blindness from glaucoma is highest.

Biomedical Technology↗
PubMedDate not supplied

Coverage options for promising technologies: Medicare's 'coverage with evidence development'.

In April 2005 the Centers for Medicare and Medicaid Services (CMS) posted on its Web site a draft guidance document describing a new approach to coverage policy called "coverage with evidence development" (CED). CED offered an option for coverage of promising drugs, biologics, devices, diagnostics, and procedures that would not otherwise meet Medicare's evidentiary standards for being "reasonable and necessary." An updated guidance was posted 12 July 2006, clarifying several key statutory, regulatory, and operational issues. This paper traces the history of this policy approach, explains the rationale behind the policy, and describes the major challenges that will need to be addressed for CED to become an important advance in evidence-based coverage decision making.

Biomedical Technology↗
PubMed2006

Disparities, cancer surveillance, and next steps.

BACKGROUND: Effective cancer surveillance is critical for understanding disparities in current cancer incidence and treatment. The years ahead will see significant changes in how surveillance can be done. METHODS: Scenarios developed for the Cancer Surveillance Futures Project identify 4 paths for the next decade (Growth--Advances in science and technology for health care and cancer control; Stagnation--Hard times, slow and unequal progress on many fronts; Choice--Creating a healthy marketplace for health care; and Transformation--Accelerating cancer control for all). RESULTS AND CONCLUSIONS: In terms of getting to near-term and longer term success with cancer surveillance, the Intercultural Cancer Council and C-Change have made several recommendations including consistent collection of socioeconomic status, risk factors, and treatment information as well as community involvement in collecting cancer information and developing cancer control approaches, developing data standards, and broadening cancer surveillance to include treatment quality, risk factor data, and preneoplastic events.

Biomedical Technology↗
PubMed2006

Comparative analysis of the risk-handling procedures for gene technology applications in medical and plant science.

In this paper we analyse how the risks associated with research on transgenic plants are regulated in Sweden. The paper outlines the way in which pilot projects in the plant sciences are overseen in Sweden, and discusses the international and national background to the current regulatory system. The historical, and hitherto unexplored, reasons for the evolution of current administrative and legislative procedures in plant science are of particular interest. Specifically, we discuss similarities and differences in the regulation of medicine and plant science, and we examine the tendency towards dichotomizing risk--focusing on social/ethical risks in medicine and biological risks in plant science. The context of this article is the Synpraxia research project, an inter-disciplinary program combining expertise in sciences and the humanities.

Biomedical Technology↗
PubMed2003

Technology and the future of cochlear implants.

Cochlear implants are one of the dramatic success stories of the bioengineering enterprise. Although these prostheses are used extensively, they still can be improved substantially. We suggest that high-density electrode designs will permit field shaping and field steering to an extent not presently possible with the arrays that are used today. Those opportunities will make it possible to make use of the phase information that is richly available to normal listeners. Although this information makes possible more precise location of sound sources in the auditory environment, and will likely improve the recognition of intelligent sound in noise, it will require the consumption of additional power in future cochlear prostheses. Those opportunities and trade-offs provide the designers of cochlear implants with exciting goals for the future.

Biomedical Technology↗
PubMed2004

Balancing traditional values in academic medicine with advances in science and technology.

Scientific discovery, population growth, and world commerce are converging to reshape medicine in unforeseen ways. Instead of responding passively to change we must embrace each challenge as an opportunity. Critical issues facing academic medicine today include a revolution in molecular biology and biotechnology, spiraling costs of health care, lack of consensus on a frame of reference for strategic planning (global versus local), and lack of appropriate methods of assessment (outcome analysis). These issues are complex and broad. Thus, it may be that the best that can emerge from our discussion is to identify the major dimensions along which progress may be expected and to predict ways in which change can be directed to serve the needs of health care institutions and medical professionals around the world. Solutions will require innovation in medical education, leadership, and international collaboration.

Academic Medical Centers↗
PubMed2007

Cost of cancer care: issues and implications.

Medical technology is increasingly costly in most fields of clinical medicine. Oncology has not been spared from issues related to cost, in part resulting from the tremendous scientific progress that has lead to new tools for diagnosis, treatment, and follow-up of our patients. The increasing cost of health care in general (and cancer care in particular) raises complex questions related to its effects on our economy and the citizens of our society. This article reviews the macroeconomic principles and individual behaviors that govern medical spending, and examines how cost disproportionately affects various populations. Our overall goal is to frame debate about health policy concerns that influence the clinical practice of oncology.

Biomedical Technology↗
PubMed2004

Safe paediatric intensive care. Part 1: Does more medical care lead to improved outcome?

Neonatal and paediatric intensive care has improved the prognosis for seriously sick infants and children. This has happened because of a pragmatic approach focused on stabilisation of vital functions and immense technological advances in diagnostic and therapeutic procedures. However, the belief that more medical care must inevitably lead to improved health is increasingly being questioned. This issue is especially relevant in developing countries where the introduction of highly specialised paediatric intensive care may not lead to an overall fall in child mortality. Even in developed countries, the complexity and availability of therapeutics and invasive procedures may put seriously ill children at additional risk. In both developing and industrialised countries the use of safe and simple procedures for appropriate periods, particular attention to drug prescription patterns and selection of appropriate aims and modes of therapy, including non-invasive methods, may minimise the risks of paediatric intensive care.

Biomedical Technology↗
PubMed2002

The future of nanofabrication and molecular scale devices in nanomedicine.

Nanotechnology is engineering and manufacturing at the molecular scale, and the application of nanotechnology to medicine is called nanomedicine. Nanomedicine subsumes three mutually overlapping and progressively more powerful molecular technologies. First, nanoscale-structured materials and devices that can be fabricated today hold great promise for advanced diagnostics and biosensors, targeted drug delivery and smart drugs, and immunoisolation therapies. Second, biotechnology offers the benefits of molecular medicine via genomics, proteomics, and artificial engineered microbes. Third, in the longer term, molecular machine systems and medical nanorobots will allow instant pathogen diagnosis and extermination, chromosome replacement and individual cell surgery in vivo, and the efficient augmentation and improvement of natural physiological function. Current research is exploring the fabrication of designed nanostructures, nanoactuators and nanomotors, microscopic energy sources, and nanocomputers at the molecular scale, along with the means to assemble them into larger systems, economically and in great numbers.

Biomedical Technology↗
PubMed2005

Applying health technology assessment to pharmaceutical care: pitfalls and future directions.

It has been argued in previous issues of this journal that health technology assessment can be used as a tool to assess the eciency of pharmaceutical care by linking its impact on clinical and humanistic outcomes to the resources required to achieve these outcomes. Additionally, as policy-makers appreciate the need to evaluate projects on the basis of their costs and benefits, the application of health technology assessment to pharmaceutical care may serve as a way of communicating with policy-makers and informing policy on pharmaceutical care. This article elaborates on this idea by arguing that policy-makers will be more likely to appreciate the value of pharmaceutical care if researchers pay more attention to some methodological principles underlying health technology assessment in the context of pharmaceutical care, and if they take into account the decision-making context facing policy-makers. In order to raise the methodological quality of studies, researchers need to take care to define better the pharmaceutical care intervention; to evaluate the costs of the intervention and its impact on the utilization of other health services; and to aggregate the various clinical and humanistic outcome measures that are commonly used in this type of research. In order to increase the usefulness of study findings to policy-makers, researchers need to identify the multiple objectives that policy-makers pursue, and show how study findings will aid policy-makers in attaining these objectives.

Biomedical Technology↗
PubMed2004

Lymnaea stagnalis and the development of neuroelectronic technologies.

The recent development of techniques for stimulating and recording from individual neurons grown on semiconductor chips has ushered in a new era in the field of neuroelectronics. Using this approach to construct complex neural circuits on silicon from individual neurons will require improvements at the neuron/semiconductor interface and advances in controlling synaptogenesis. Although devices incorporating vertebrate neurons may be an ultimate goal, initial investigations using neurons from the pond snail Lymnaea stagnalis have distinct advantages. Simple two-cell networks connected by electrical synapses have already been reconstructed on semiconductor chips. Furthermore, considerable progress has been made in controlling the processes that underlie chemical synapse formation in Lymnaea. Studies of Lymnaea neural networks on silicon chips will lead to a deeper understanding of the long-term dynamics of simple neural circuits and may provide the basis for reliable interfaces for new neuroprosthetic devices.

Animals↗
PubMed2006

[Guidelines for health-economic evaluations in Austria].

BACKGROUND: The evaluative health economics is a recent field of research in health economics. Cost-effectiveness decisions play an increasing role, particularly for policy-makers to find systematic decisions under uncertainty. The task is all the more important as the use of innovative health technologies for diagnosis, prevention and treatment is rapidly expanding and thus leads to financial restrictions in health care. Hence, decision making has to be supported by systematically implementing analytical tools. METHODS: When it comes to interpret the results of health-economic evaluations in a valid way it is necessary that state-of-the-art methodology is carried out in a transparent way. It is in this vein that guidelines were developed for Austria. On the one hand, they should set standards but, on the other hand, they should not restrict methodical progress guided by freedom of scientific research in health economics. CONCLUSIONS: Setting guidelines of health-economic evaluations is an important breakthrough in Austria.

Administrative Personnel↗
PubMed2005

In support of emergency department health information technology.

Emergency department visits represent a significant portion of medical care. Emergency physicians require immediate access to clinical information in order to provide quality care. Increased medical errors result when access to the complete medical record is limited. Clinicians' access to clinical information is limited to the greatest extent when care occurs over short time intervals, and between separate healthcare systems. Over the four-year period, the majority (85%) of all patients, stay within the same system; however, of patients with more than one visit, this percentage decreases to 66%. Of patients who return within 24 hours, 75% return to the same hospital or healthcare system. This patient population represents a unique cohort with special healthcare needs. Not only do they represent a disproportionate share of visits compared to those remaining within a single system but they also represent additional, and often underestimated, opportunities to provide quality care.

Biomedical Technology↗
PubMed2005

Micro and nano technology enabling ambient intelligence for P-Health.

This chapter will discuss the ongoing development and integration of micro and nano technologies within the Tyndall National Institute that will enable the future vision of ambient intelligence with specific application to the area of personalised health (P-Health). Ambient Intelligent Systems open entirely new possibilities for future applications and resultant markets. Ultimately, these systems will create intelligent environments that cater continuously for the requirements of the individual in everyday life and apply it in a totally coherent manner. They will learn and evolve to anticipate user-requirements. We will discuss ongoing research in the areas of sensors, sensor interfacing, interconnection and packaging, hardware platforms, infrastructure and power delivery for ambient systems with applications in the p-health domain.

Biomedical Technology↗