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PubMedDate not supplied

Non-lethal weapons technologies--the case for independent scientific analysis.

Various technologies have been proposed for non-lethal weapons (NLW), some of them credible, or at least plausible, but strong claims were made for others without evidence or references. Five such technologies are examined. For the chemical and biological examples, detailed information is lacking but the diminishing number of such claims over time and general scientific knowledge suggest that fulfilment of the promises is improbable. For acoustic weapons, a detailed study found that many of the claims are plainly untrue. In this case, even wrong values for physiological thresholds were presented. Civil and military NLW programmes in the USA put their main emphasis on simple, short-term technologies rather than exotic ones. In order to avoid dangers arising from unrealistic promises, the concept of preventive arms control should be applied to NLW. Its first step is a scientific analysis, investigating the new weapons, the propagation of their effects and the effect on the targets. Such detailed studies are needed for each proposed NLW technology.

Acoustics↗

PubMed2004

Older adults' attitudes towards and perceptions of "smart home" technologies: a pilot study.

PRIMARY OBJECTIVE: The study aim is to explore the perceptions and expectations of seniors in regard to "smart home" technology installed and operated in their homes with the purpose of improving their quality of life and/or monitoring their health status. RESEARCH DESIGN AND METHODS: Three focus group sessions were conducted within this pilot study to assess older adults' perceptions of the technology and ways they believe technology can improve their daily lives. Themes discussed in these groups included participants' perceptions of the usefulness of devices and sensors in health-related issues such as preventing or detecting falls, assisting with visual or hearing impairments, improving mobility, reducing isolation, managing medications, and monitoring of physiological parameters. The audiotapes were transcribed and a content analysis was performed. RESULTS: A total of 15 older adults participated in three focus group sessions. Areas where advanced technologies would benefit older adult residents included emergency help, prevention and detection of falls, monitoring of physiological parameters, etc. Concerns were expressed about the user-friendliness of the devices, lack of human response and the need for training tailored to older learners. CONCLUSIONS: All participants had an overall positive attitude towards devices and sensors that can be installed in their homes in order to enhance their lives.

Accidental Falls↗

PubMed2000

Isolation technology for research and development applications: from concept to production.

A prototype parenteral manufacturing facility based on isolation technology was designed, constructed, and commissioned at Warner-Lambert Co., Morris Plains, NJ, with emphasis on its application to research and development (R&D) settings. The facility contains closed isolators for holding, transferring, and manufacturing sterile products. Vaporized hydrogen peroxide (VHP) was used for sanitization of the isolators. Various factors were evaluated to ensure complete distribution of VHP inside the isolators. VHP sanitization validation of the isolators was performed using chemical and biological indicators, and by swab testing the inside surfaces of the isolators. On the basis of these studies, operating conditions for routine VHP sanitization of the various isolators were established. Performance qualification of the manufacturing facility was conducted via media fills, which demonstrated sterile integrity of the manufacturing process. The media fills revealed certain deficiencies in handling procedures of filled product, which were subsequently corrected. The Warner-Lambert isolation technology-based parenteral facility proved to be a reliable and cost-effective alternative to standard clean room technology. The facility is ideally suited for manufacturing small batches. Closed isolator technology has its limitations when used for production-size batches involving automated processing.

Hydrogen Peroxide↗

PubMed1990

High technology in health care.

The structure of the Assistance Publique-Hôpitaux de Paris renders necessary an inhouse centralized technology assessment unit. This unit, named CEDIT (Committee for the Evaluation and the Diffusion of Innovative Technologies), has been functioning since 1982 and has advised the Director General on 70 new technologies, including the lithotriptor and plasma-exchange therapy. A particular feature of the CEDIT is that it is in charge of both the assessment and the implementation of the recommendations following this assessment. We attempt to describe the consequences of the CEDIT's functioning compared to other countries' technology assessment organizations.

Evaluation Studies as Topic↗

PubMed2006

Iron fortification technology development: new approaches.

The objective of our fortification technology development has been to deliver meaningful levels of bioavailable iron via commonly consumed foods and beverages without compromising taste, appearance, and stability. However, fortification of foods is accompanied with unsolved problems such as unacceptable taste, color, stability, and bioavailability. To solve these problems, we developed a fortification technology that prevents the iron-mediated undesirable taste and appearance of the final product while preserving stability and bioavailability. Iron was stabilized by applying principles of colloid chemistry (encapsulation), chelation, and electrochemical chemistry (redox modulation). Results from color and sensory evaluations showed that formulation of products using the new fortification technology known as "GrowthPlus" eliminated detrimental effects on taste, appearance, and product stability. Bioavailability evaluation using animal models and human subjects showed the GrowthPlus technology does not interfere with the bioavailability of iron from either ferrous bis-glycinate or ferrous fumarate. Multiple intervention trials showed that repeated consumption of the redox stabilized iron in the form of a powdered fruit beverage increased iron status indicators (hemoglobin and ferritin) and reduced iron deficiency anemia significantly in school children, adolescent girls, and pregnant women.

Adolescent↗

PubMed2006

Minimally invasive pharmacokinetic and pharmacodynamic technologies in hypothesis-testing clinical trials of innovative therapies.

Clinical trials of new cancer drugs should ideally include measurements of parameters such as molecular target expression, pharmacokinetic (PK) behavior, and pharmacodynamic (PD) endpoints that can be linked to measures of clinical effect. Appropriate PK/PD biomarkers facilitate proof-of-concept demonstrations for target modulation; enhance the rational selection of an optimal drug dose and schedule; aid decision-making, such as whether to continue or close a drug development project; and may explain or predict clinical outcomes. In addition, measurement of PK/PD biomarkers can minimize uncertainty associated with predicting drug safety and efficacy, reduce the high levels of drug attrition during development, accelerate drug approval, and decrease the overall costs of drug development. However, there are many challenges in the development and implementation of biomarkers that probably explain their disappointingly low implementation in phase I trials. The Pharmacodynamic/Pharmacokinetic Technologies Advisory committee of Cancer Research UK has found that submissions for phase I trials of new cancer drugs in the United Kingdom often lack detailed information about PK and/or PD endpoints, which leads to suboptimal information being obtained in those trials or to delays in starting the trials while PK/PD methods are developed and validated. Minimally invasive PK/PD technologies have logistic and ethical advantages over more invasive technologies. Here we review these technologies, emphasizing magnetic resonance spectroscopy and positron emission tomography, which provide detailed functional and metabolic information. Assays that measure effects of drugs on important biologic pathways and processes are likely to be more cost-effective than those that measure specific molecular targets. Development, validation, and implementation of minimally invasive PK/PD methods are encouraged.

Antineoplastic Agents↗

PubMed1999

Slaughter technology.

Slaughter technology has changed dramatically over the past 30 yr. Methods of handling the live animal immediately prior to slaughter, methods of stunning, killing, early postmortem handling, and carcass treatment have all seen technological advancement. The primary factors driving changes in these technical aspects of poultry slaughter have been to increase efficiency of commercial operations and the improvement of carcass and meat quality. Paralleling these developments, changes in social and legal expectations regarding animal well-being have also had an impact on these technical developments. The purpose of this symposium is to review the developments of these changing technologies and how they are being implemented in commercial operations. Special emphasis is on the technologies of electrical stunning, gas stunning, and electrical stimulation and their effects on carcass and meat quality.

Abattoirs↗

PubMed1995

Complexity in selecting health care technology in diverse settings.

Nurses in diverse settings around the world work toward improving human health. Attainment of this goal depends, in part, on selecting and using appropriate technology. The article describes the framework of technology assessment and suggests ways in which nurses can be involved in evaluating health care technologies, deliberating on appropriate applications, and, if not selecting, then at least having input into the selection of technologies from the individual patient level through and including health policy.

Choice Behavior↗

PubMedDate not supplied

Information technology: changing nursing processes at the point-of-care.

Changing societal demographics, increasing complexity in healthcare knowledge, and increasing nursing shortages have led healthcare strategists to call for a redesign of the healthcare system. Embedded within most redesign recommendations is the increased use of technology to make nursing practice more efficient. However, information technology (IT) has the potential to go beyond simple efficiency increases. If IT is perceived truly as a part of the redesign of healthcare delivery rather than simply the automation of existing processes, then it can change nursing processes within institutions and furthermore change the point-of-care between nurses and patients. Nursing adoption of technology within the workplace is a result of the interactions between technical skills, social acceptance, and workplace culture. Nursing needs for information not only influence their adoption of particular technologies but also shape their design. The objective of this article is to illustrate how IT can change not only nursing practice and processes but also the point-of-care. A case study of the use of IT by nurses in telehomecare is presented and administrative implications are discussed.

Attitude of Health Personnel↗

PubMedDate not supplied

Aging well with smart technology.

As baby-boomers age, the need for long-term nursing care services increases. In the future, there will simply not be enough long-term care facilities to accommodate all of these patients. In addition, many people prefer to grow old at home, a concept known as aging-in-place. Smart home technology facilities aging-in-place by assisting patients with emergency assistance, fall prevention/detection, reminder systems, medication administration and assistance for those with hearing, visual or cognitive impairments. Benefits include making aging-in-place a reality, continuous monitoring, and improved psychosocial effects. Concerns of this technology include cost, availability of technology, retrofitting complications, and potential inappropriate use of the technology. Overall, the concept of smart homes is gaining in popularity and will expand the role of the nurse in the future. It is important for all nurses to understand how their practices will be transformed as smart homes become a reality for the aging population.

Accidental Falls↗

PubMed2004

Quality improvement in an outpatient department for subacute low back pain patients: prospective surveillance by outcome and performance measures in a health technology assessment perspective.

STUDY DESIGN: Prospective cohort study. OBJECTIVES: To develop clinical indicators and standards in an outpatients' department for sub acute low back pain patients. SUMMARY OF BACKGROUND DATA: A systematic quantitative surveillance to assess quality of care was implemented using outcome and performance measures. These measures were developed within the framework of Health Technology Assessment, which comprises the areas of healthcare technology, patient, organization, and economy. METHODS: A multidisciplinary project group defined 1) clinical indicators in terms of outcome and performance measures and 2) the corresponding standards using the available evidence from literature. Observed outcomes were compared with the standards. Associations between process and outcome measures were investigated. RESULTS: A total of 300 patients were included consecutively. In relation to technology, the standards for the field of application were fulfilled (e.g., not too many patients were x-rayed). With respect to effectiveness, the observed rate of patients reaching a 50% cutoff point of improvement of pain and function did not fulfill the standards. In relation to patient aspects, the standards of, for example, proper understanding of patient education and satisfaction, were fulfilled. In relation to organization, nearly one third of the patients were referred later to the department than the recommended 24 weeks. This refer variable showed an association to a reduced chance of scoring "better" or "much better" in "patients global assessment." The chance was reduced by 50% if patients were referred later than 12 weeks after onset of pain. In relation to economy, the cost of gaining a quality adjusted life-year by a course in the department was considerably lower than by comparison with total hip arthroplasty. CONCLUSIONS: Surveillance by clinical indicators in relation to the four areas of health technology assessment provides quantitative information that is meaningful for various stakeholders on important aspects of the quality of care (including consumers), provides a basis for quality improvement, and provides data for analysis of possible important relationships between structure, process, and outcome.

Acute Disease↗

PubMed1993

The intersection of technology and care in the ICU.

In this article the author describes the paradoxical nature of the relationship between technology and care in the ICU. Although technology enhances care by expanding the repertoire of competent nurses' responses to the patient, it simultaneously alienates nurse and patient, hence inhibiting care. This occurs when nurses and patients have different understandings of technology and when the nurse identifies with the values imposed by technology at the expense of acknowledging her own and the patient's vulnerability.

Critical Care↗

PubMed2003

Living and dying with medical technology.

Medical technology is a two-edged sword, capable of saving and improving life but also of ending and harming life. Finding the right stance toward technology requires great balance and sensitivity. It has seductive powers because of its expected benefits, the social and professional pressures to use it, and a frequent confusion that results from confusing the sanctity and value of human life with a supposed imperative always to use technology. The aim of good critical care medicine should be to establish a meaningful tension, particularly in the care of those patients threatened with death, between the aim of preserving life, on the one hand, and making possible a peaceful death, on the other. Any automatic bias in favor of using technology will threaten that latter possibility.

Critical Care↗

PubMed2005

A perspective on DNA microarray technology in food and nutritional science.

PURPOSE OF REVIEW: The functions of nutrients and other foods have been revealed at the level of gene regulation. The advent of DNA microarray technology has enabled us to analyze the body's response to these factors in a much more holistic manner than before. This review is intended to overview the present status of this DNA microarray technology, hoping to provide food and nutrition scientists, especially those who are planning to introduce this technology, with hints and suggestions. RECENT FINDINGS: The number of papers examining transcriptomics analysis in food and nutrition science has expanded over the last few years. The effects of some dietary conditions and administration of specific nutrients or food factors are studied in various animal models and cultured cells. The target food components range from macronutrients and micronutrients to other functional food factors. Such studies have already yielded fruitful results, which include discovery of novel functions of a food, uncovering hitherto unknown mechanisms of action, and analyses of food safety. SUMMARY: The potency of DNA microarray technology in food and nutrition science is broadly recognized. This technique will surely continue to provide researchers and the public with valuable information on the beneficial and adverse effects of food factors. It should also be acknowledged, however, that there remain problems such as standardization of the data and sharing of the results among researchers in this field.

Consumer Product Safety↗

PubMed2005

Technology diffusion, hospital variation, and racial disparities among elderly Medicare beneficiaries: 1989-2000.

BACKGROUND: Low rates of technology utilization in hospitals with high proportions of black inpatients may be a remediable cause of healthcare disparities. OBJECTIVES: Our objective was to determine how differences in technology utilization among hospitals contributed to racial disparity and if temporal reduction in hospital procedure rate variation resulted in decreased racial disparity for these technologies. METHODS: We identified 2,348,952 elderly Medicare beneficiaries potentially eligible for 1 of 5 emerging medical technologies from 1989-2000 and determined if these patients had received the indicated procedure within 90 days of their qualifying hospital admission. Initial multivariate regression models adjusted for age, race, sex, admission year, clinical comorbidity, community levels of education and income, and academic/urban hospital admission. The inpatient racial composition of each patient's admitting hospital and time-race interactions were added as covariates to subsequent models. RESULTS: Blacks had significantly lower adjusted rates (P < 0.001) compared with whites for tissue replacement of the aortic valve, internal mammary artery coronary bypass grafting, dual-chambered pacemaker implantation, and lumbar spinal fusion. Hospitals with > 20% black inpatients were less likely to perform these procedures on both white and black patients than hospitals with < 9% black inpatients, and racial disparity was greater in hospitals with larger black populations. There were no temporal reductions in racial disparities. CONCLUSIONS: Blacks may be disadvantaged in access to new procedures by receiving care at hospitals that have both lower procedure rates and greater racial disparity. Policies designed to ameliorate racial disparities in health care must address hospital variation in the provision of care.

Aged↗

PubMed1980

Appropriate technology: the challenge of the second generation.

Appropriate technology, defined here as a low-cost technology aimed at helping to meet the most basic needs of the world's poorest people, can only be a viable proposition if its proponents succeed in making the transition from the first to the second generation, i.e. from the small-scale experiments and pilot innovations of today, to the massive application of new devices (hardware) and new forms of organization (software). The main agents in this second generation are national planning institutions, government ministries, established research centres, development agencies, financial institutions and industral corporations. Some of the ways in which this transition can be facilitated are examined, as well as a number of specific issues such as intelligence policies in appropriate technology, the structure of decision-making mechanisms and the linkage between appropriate technology and overall development strategies.

Agriculture↗

PubMed2004

After the euphoria: HIV medical technologies from the perspective of their prescribers.

This paper focuses on the relationship of HIV medical technologies to current styles of medical practice and highlights issues posed by the technologies for those working and/or living with HIV. The paper examines HIV anti-retroviral combination therapies and associated tests from the perspective of their prescribers. The prescribers were interviewed during the later part of 2002 at three London HIV clinics. Their comments, considered in light of other recent studies in the field, suggest that current therapies are part of a transitional phase in the epidemic which informs the identification and negotiation of known risks and uncertainty. An undetermined but extended life expectancy, afforded by anti-retroviral therapies, is understood against risk of iatrogenic diseases and/or viral drug resistance. The tension arising in this situation of unwanted and even uncertain phenomena poses ethical dilemmas and affects doctor/patient relations. Indeed, it also contributes to a reconfiguring of the lived experience of managing HIV. While the new technologies have offered considerable advances in the medical management of HIV, they are altering the nature of HIV medicine both materially and socially. The scenario is further complicated by the uneven allocation of resources and different patient health and disease states. The heterogeneity of resources, disease states and technological effects points to the need for ongoing and extended evaluation as the relationship between these and the everyday practice of medicine continues to change.

Antiretroviral Therapy, Highly Active↗

PubMed1995

Technology seduction: lost opportunities in child health?

This report examines the extent to which illness-based individual care and expensive, often unevaluated, technologies in paediatrics have seduced practitioners away from more cost-effective, population-based child health activities and examples of new and unevaluated technologies in perinatology and paediatrics are given. The way in which these technologies are introduced and taken up, by 'creeping incrementalism', is described and a plea is made to implement only those aspects of paediatric care that have been demonstrated to be effective. This would result in only appropriate technologies being used, avoid harm being done to children and ensure that money is available for other effective population-based activities that improve child health.

Australia↗