PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Technology--changes”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources

Continuing education/beyond higher education.

Publicly funded institutions, such as NIH, NLM, and state-supported universities, have explicit public service missions that extend beyond the walls of a single institution. During the past few years, national organizations, such as NLM and AAMC, have funded studies and projects to measure how well universities are adapting to technological change and educational reform. The IAIMS models are evidence of universities fostering cooperative rather than duplicative effort. Opportunities and problems facing universities extending systems and services to the private practice setting, to community-based health care HMO's, and to state and local health care agencies are discussed in terms of political, economic, and geographic realities. Instilling lifelong learning concepts begins before the health professional enters practice and is dependent on the emphasis universities place on "excellence in teaching." Without cooperation among core facilities, such as libraries, computer centers, and excellent instructors, continuing education will remain a parochial issue instead of a national thrust toward the continuum of the learning process. If continuing education is to become a high priority for universities and take its place on the education spectrum, flexible policies must be established to accommodate individual practitioners' expectations and interests.

Computers↗

[Conclusions from field studies of stress on miners caused by dry-hot climate conditions].

The physical strain of miners in hot salt mines based on analyses of heart-rates, deep body temperatures, and sweat-rates during real work was studied. Based on these results changes in the working conditions have been realized (air-conditioning of cabins or ambient air, technological changes, workpause-regimes). Cooling-wastes are not sufficient to reduce the thermal strain in hot-dry climate in normal work of salt-mines, independent of the principle of cooling. During fire-fighters work the physical work is the more dominating stressor in relation to the thermal strain.

Climate↗

Update on laboratory studies and relationship to rheumatic and allergic diseases.

Guidelines have been presented for the optimal selection and interpretation of various laboratory tests related to rheumatologic, immunologic, and allergic disorders. The last decade has witnessed many technologic changes in the performance of screening tests for autoantibodies, and an expeditious approach to the detection of the clinically useful autoantibody system has been outlined. When both an immunofluorescent assay using an actively dividing substrate such as HEp-2 and an immunodiffusion test for precipitin autoantibodies are performed on patient sera, it is likely that most of the significant diagnostic and prognostic systems will be detected. Although exact pathogenetic roles have not been defined for all autoantibodies, it is apparent that highly specific markers for certain rheumatic diseases exist and the pertinent clinical aspects of each individual autoantibody-autoantigen system has been summarized. Why so many autoantibodies are cross-reactive with seemingly unrelated antigens is a perplexing aspect of autoimmunity, a disease process for which the necessary and sufficient conditions of development have not been defined even after decades of research. One recent hypothesis regarding the generation of diverse autoantibodies is the tenet that production is interrelated in an auto-anti-idiotypic network. Support for this hypothesis comes from the recent successful use of anti-idiotypes to DNA autoantibodies in an attempt to abrogate pathogenetic effects of target organ damage in murine models of SLE. A similar approach might be undertaken with some of the other autoantibody systems in an attempt at a novel therapy for disorders of immunoregulation.

Animals↗

Rural community hospitals and factors correlated with their risk of closing.

The issue of rural hospital closings in the United States in recent years has become of increasing concern to health care policy analysts. Rural communities face unique health needs, necessitating access to local health care. Much has been written about the social, economic, legislative, and technological changes that have increased the stress on rural hospitals in the 1980s. However, quantifiable models have been lacking with which to examine in detail factors associated with rural hospitals and to correlate such factors with individual hospitals' risks of closing. In this study, we identify variables correlated with rural community hospital closures in the period 1980-87. Using epidemiologic case-control methods, 161 closed rural hospitals were matched 1 to 3 with a control group of 483 rural hospitals which remained open during the same period. A series of hospital performance indicators and demographic, economic, and social community variables were entered into a multiple logistic regression model. Four variables were found to be positively correlated with risk of closure. They are for-profit ownership; nongovernment, not-for-profit ownership; presence of a skilled nursing or other longterm care unit; and the number of other hospitals in the county. Variables negatively correlated with risk of closure were accreditation by the Joint Commission on the Accreditation of Healthcare Organizations, the number of facilities and services, and membership in a multihospital system. Policy and research implications at the Federal, State, and local levels are discussed.

Accreditation↗

Social well-being: the future of the social and health care systems.

There are signs that the American public is becoming more concerned than in the previous decade with issues of compassion such as helping the poor, giving families a better break, helping children and people of color. Concern about the nation's vulnerable groups is increasing at a time of particularly profound societal change. The nation is aging demographically, vast technologic changes have displaced masses of workers, there are sharper economic contrasts than ever between the "haves" and "have-nots," and family structure is changing dramatically. In this era of change there are increased pressures on health care professionals, particularly in terms of fiscal constraints and public demands for accountability. At this time, we recommend moving toward a unified social well-being system which incorporates medical care,health care, and social services in a manner that makes the most efficient use of limited resources.

Delivery of Health Care↗

Emergence of rheumatic fever in the nineteenth century.

How do we make sense of the process of disease definition when the tools for "framing" a pathophysiologic reality and the reality to be framed may have both been changing? The sudden emergence of rheumatic fever at the end of the eighteenth century was the result of distinct biological changes that led to cardiac damage. But the identification of the disease also depended on the ability of clinicians to diagnose it in the absence of easily observable cardiac symptoms. Clinicians were able to appreciate the alteration of rheumatism into rheumatic fever through assimilation of technological changes (the stethoscope and autopsy), refinements in clinical thinking (the "typical case"), and the concentration of patients in hospitals where they were treated by physicians who were medical leaders and educators.

History, 18th Century↗

[New problems in occupational medicine: findings on the risk of coronary heart disease in the services industry].

The distribution of the major coronary risk factors: total and HDL cholesterol, blood pressure, smoking and body mass index, was studied during the course of a routine screening of 1404 male bank employees in Northern Italy. The recent Italian and international consensus conferences and particularly the results from the Italian areas of the WHO-MONICA Project were taken as reference points. There was a widespread coronary risk in the bank employees who had a 5-10% excess of cholesterol, corresponding to a 10-20% increase in the theoretical risk of coronary heart disease. Compared to the data produced by the Lipid Research Clinics (USA), coronary risk appeared higher for all the surveyed factors in the Italian general population, and particularly in bank employees. Greater stress at home and at work and above all the change from the traditional, poor Mediterranean diet to a richer diet might provide an explanation for these results. A new perspective is thus opened for occupational health due to the new health problems produced by the cultural and technological changes occurring in the country.

Adult↗

Using the microbiology laboratory in the diagnosis of pneumonia.

Pneumonia/influenza is one of the top ten leading causes of mortality in the United States each year. The identification of the etiologic agent responsible for lower respiratory tract infection plays an important role in the proper management of this clinical problem. The specimens submitted for evaluation are obtained in diverse ways and include expectorated sputum, material from transtracheal and bronchoscopic procedures, pleural fluid and lung aspirates, and biopsy of actual lung tissue. Processing of material can include stained smears, aerobic and anaerobic cultures, and special processing techniques for fungal, viral, Pneumocystis carinii, Legionella, mycobacterial, and mycoplasma identification. Modifications of smear preparation techniques and application of the new DNA probe technology are providing the opportunity for rapid microbiologic testing of clinical specimens with increased sensitivity and specificity, often obviating the need for invasive diagnostic procedures. Laboratory methodology is continually undergoing technological change, and optimal care of the patient with pneumonia requires close cooperation between the attending physician and the clinical laboratory.

Bacteriological Techniques↗

Healthy family functioning: a cross-cultural appraisal.

It is increasingly recognized that rapid cultural, social, economic, and technological changes are imposing increasing stress on family structures, traditional values, and the ability to adapt to new environments in different societies. For the purposes of this paper, "healthy family functioning" is defined in terms of a family unit (however it is conceived in any given culture) effectively coping with cultural, environmental, psychosocial, and socioeconomic stresses throughout the family life cycle. While a review of international literature in the behavioural and biomedical sciences yields little data on comparative studies, there is growing awareness of the need for cooperative international research on family coping mechanisms and determinants of self-reliant communal coping behaviour, as well as more efficient utilization of already available knowledge. After consideration of methodological pitfalls of assessment procedures, there is a presentation of an evolving theory of healthy family functioning with the suggestion that studies of young married couples constitute a particularly promising vehicle for developing needed cooperative cross-cultural research.

Cross-Cultural Comparison↗

Assessment of changing technologies in medicine.

Technology is the outcome of man's use of tools and reason to change the environment to his benefit. New technology creates opportunities for some and threats for others. New technology will be dramatically influenced by the political, social, economic, and ethical milieu in which it develops. An overriding concern in the near future may be cost. Cost-benefit analysis/cost-effectiveness analysis can be a helpful planning tool but should not be used exclusively to plan for technological change. Knowledge of the humanities as well as a science will be essential if we are to make the decisions needed as we approach the 21st century.

Cost-Benefit Analysis↗

Prospective payment assessment commission. A commissioner's perspective.

The function and priorities of the Prospective Payment Assessment Commission (ProPAC) are discussed. The ProPAC's priorities include (1) safeguarding the quality of care; (2) encouraging hospital productivity and long-term cost-effectiveness; (3) facilitating innovation and appropriate technological change; (4) maintaining stability for providers, consumers, and other payers; and (5) making decisions based on reliable, timely data and information.

Cost-Benefit Analysis↗

The importance of embryological research in the surgical management of the cleft lip deformity.

The cleft lip deformity has been present throughout mankind, and has entered into the folklore of Nations. There has been a multitude of described repairs. Still they do not provide the hoped for final results. Some of the changes have been based on "thought out" ideas, others on futile guesses. The last few years have seen changes in the surgical direction due to a clearer understanding of the basic embryology. These changes have been made possible by advances in equipment and technology. Changes in animal research, both intra- and extra-uterine, have made possible experiments which may answer some of the suppositions put forward covering both development and healing. The classification of cleft lip places all the deformities in one group, but there may in fact be several groups with different actual causes and failures leading to the same clinical picture. The understanding of the failure or failures that occur in development should lead to a logical approach to the repair of the cleft deformity.

Cleft Lip↗

Teaching medical professionals to retrieve and manage medical information.

Popularity of the personal computer has prompted physician interest in direct access to the medical literature from sophisticated electronic data retrieval systems. This paper describes the educational programs developed by the library at the George Washington University Medical Center in response to this interest and growing national trend. As a result of these programs, the role of the librarian has changed permanently. Librarians are now perceived by faculty as educational specialists and information consultants. The evolution in libraries parallels the technological changes taking place in other biomedical communications units. The authors recommend the positive outcomes from adapting traditional roles to meet user's needs in a changing environment.

Humans↗

Health care in transition. Consequences for young physicians. Council on Long-Range Planning and Development.

Individuals planning for a career in medicine must weigh a number of factors into their decisions. Increasingly, they must understand the nature of the socioeconomic environment of health care, including the extent of competition with other physicians and other health professionals; the degree of autonomy from health care institutions, government, and third-party payers; the impact of demographic or technological changes; and the economics of medical practice. This report analyzes the environment of medicine, emphasizing those elements that will be most important to medical students and resident physicians. It focuses on three stages of a physician's career: obtaining a medical education, beginning to practice medicine, and maintaining a viable practice.

Adolescent↗

High technology medicine: how defined and how regarded.

High technology--complex, expensive, restricted in availability, and requiring some form of explicit rationing--is bound to influence the medical task. Diagnosis, prognosis, decision, and management have all incorporated high technology, changing the hospital physician's role from one of private contractor to one of team member. Attitudes toward the balance between burden and benefit of high technology are as varied as are the conflicting vested interests among patients, professionals, society, industry, and government. Above all, it will take time for both patients and professionals to learn how to redefine expectations in a changing relationship.

Attitude↗

Regulatory agencies and food safety.

Prior to Confederation, food control legislation in Canada consisted of only a few simple laws governing the quality, grading, packing and inspection of certain staple foods. The Inland Revenue Act of 1875 provided the first real control in Canada over adulteration of liquor, foods and drugs. Since then, food legislation has evolved in scope and complexity as the industries involved have developed, as consumers have become better informed, and as scientific advances have provided a sound basis for regulations. Present regulations under the Food and Drugs Act are intended to give consumers broad protection against health hazards and fraud in the production, manufacture, labelling, packaging, advertising, and sale of foods. This principle is well illustrated by present requirements for the control of pesticide residues, chemical additives, and the addition of vitamins to foods. In today's era of rapid technological change, application of current scientific knowledge to the food industry obviously involves the possibility of hazards to health. Regulatory agencies with responsibility for food safety must, therefore, fully utilize scientific knowledge in order to reduce the risks involved to a minimum.

Canada↗

Assessing trends in perinatology.

Hospital administrators must respond as the medical profession renews its efforts to reduce newborn mortality rates. Technological changes in the case of obstetric and newborn patients, pressures for the regionalization of service, and consumer demands for a more humane birth environment are factors the administrator must consider.

Consumer Behavior↗

Radiology 1984. A conflict of high technology and high cost.

Radiology is confronted now by exciting but challenging times. The excitement derives from dramatic technological advance; the challenge from the economic constraints on health care delivery. The large and growing expense of providing health care is readily apparent and high technology medicine can too easily be blamed for the growth. The pressures for improved service at no extra cost will demand much of the negotiating skills of our specialty and our ability to survive administrative confusion and fragmentation. Equally, manpower planning is a feature of modern medicine. Often this is done from inadequate data and as a specialty we must continue to think constructively about our own future in this context, not least in recognizing the contribution of women to our specialty. Forces also to be recognized are decentralization, electronic information transfer, concerns about radiation exposure and litigation. Not least we need to be better able to define our specialty as its scope is now changing rapidly. For the future I hope that we can be part of the development of the controls which we must inevitably face; we should lead in instituting cost-accounting in our departments; we must be at the leading edge of technological change in both imaging and data transfer, and we must be both more business-like as well as act effectively as the patient's advocate. Radiology has an important and growing responsibility in patient care and most of the technological advances both improve that care and can be justified economically. I am proud to be a radiologist in 1984.

Canada↗