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Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured.
The following types of contributions and areas are considered:
1. Original articles:
Technology development in medicine: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine.
Significance of medical technology and informatics for healthcare: The appropriateness, efficacy and usefulness deriving from the application of engineering methods, devices and informatics in medicine and with respect to public health are discussed.
2. Technical notes:
Short communications on novel technical developments with relevance for clinical medicine.
3. Reviews and tutorials (upon invitation only):
Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented.
4. Minisymposia (upon invitation only):
Under the leadership of a Special Editor, controversial issues relating to healthcare are highlighted and discussed by various authors.
Abstract: It has been suggested that quantitative ultrasound (QUS) could be used as a selective population pre-screen, to maximise the cost effectiveness of referral for dual energy X-ray absorptiometry (DXA) assessment of bone mineral density (BMD). We set out to examine how such an approach might perform in the assessment of women who were referred by general practitioners for DXA via the open access service in Cardiff. In 115 women aged 40–80 (mean 69) years we used DXA to measure BMD at lumbar spine and hip, and QUS to measure broadband ultrasound attenuation (BUA) in the heel. A bottom-up approach was…used to estimate the costs of DXA and QUS. We examined the cost effectiveness of using QUS as a pre-screen, only referring subjects for the more expensive DXA assessment if BUA were less than a pre-determined threshold. The unit costs of pencil-beam DXA and QUS were approximately £44 and £16 respectively. We identified a BUA threshold of 60 dB/MHz as the most cost effective, and calculated a sensitivity of 81% and specificity of 89% in identifying those subjects whom DXA assessment subsequently identified as having osteoporosis. At the BUA threshold of 60 dB/MHz, pre-screening saved £969 at the expense of missing ten women with osteoporosis as diagnosed by DXA. Therefore the cost per additional woman with osteoporosis identified using DXA alone was only £97. QUS assessment does not appear to have a significant cost effective benefit as a pre-screen for DXA in the studied population. A QUS pre-screen would be cost effective only if this investigation could be performed at a substantially lower cost.
Abstract: Chronic diseases do not only manifest themselves as sets of pathophysiological factors. They bring about an equally important psychosocial impact. Unfortunately, it is difficult to account for this impact in the development of supportive technologies. This study describes and explores a method for elicitation of requirements on technologies supporting self-management including emotional aspects. The method takes advantage of a self-documentary media kit for collection of data from the everyday context of chronic disease. The resulting contextual data can contribute new insights to multi-disciplinary teams in the design of supporting technologies.
Keywords: design of supportive technologies, cultural probes, self-documentary video, chronic disease, patient education, adolescents, participatory action research
Abstract: Introduction: We evaluated the accuracy of a disposable, sterile thermometer that is practical in use and holds no risk of cross-infections. Methods: a cross-sectional study was set up in which we compared the Tempa Dot® with the mercury thermometer in adults and children. Subjects were recruited from general practice and a paediatric ward. The mercury thermometer was used orally in subjects over 2 years of age and rectally in children up to 2 years old. The Tempa Dot® was used either orally or axillary. Results: The total population consisted of 212 patients, of which…131 children were younger than 16 years old. Their mean age was 17.3 years old, ranging from 1 month to 76 years. The mean difference between the mercury thermometer and the Tempa Dot® , used orally or axillary, was 0.04°C. For children between 0 and 16 years old, the mean difference was 0.08°C. Agreement between the two methods as assessed with regression analysis and Bland and Altman plots was very good. ROC curve analysis suggests cut-off points of 37.2 and 37.6°C to detect fever for the Tempa Dot® at the oral and the axillary site respectively. Sensitivity and specificity were 100.0% and 79.0% for the total population, measuring orally and 100.0% and 95.9% axillary. In children, sensitivity and specificity were 100.0% and 83.1% orally, and 100.0% and 95.4% axillary. Using a single cut-off point for both measuring sites, namely 37.5°C, sensitivity dropped and specificity increased for the oral site. For the axillary site, sensitivity remained unchanged and specificity was somewhat less. Conclusion: the Tempa Dot® is a reliable alternative for the mercury thermometer. In clinical use, a cut-off point of 37.5°C for both the oral and axillary site is most appropriate.
Keywords: diagnostic studies, method comparison, thermometer, body temperature, Sensitivity, fever
Abstract: It is assumed that bone mineral density (BMD) measurement by dual-energy X-ray absorptiometry (DXA) has its limitation in identifying bone strength, and therefore other methods should be developed. Non-invasive strength measurement, which is needed to diagnose and monitor metabolic bone diseases such as osteoporosis, can become an alternative to current methods. In this study, mechanical vibration analysis was compared to BMD measured by DXA in human female tibia. Seven mother (Ms) and daughter (Ds) pairs' (total n = 14) left and right tibiae were evaluated by DXA and mechanical vibration analysis. Mechanical vibration analysis was consistent in the same bone…and also in both sides. Correlation between BMD measured by DXA and vibration analysis was found in the Ds and Ms groups; the former being stronger than the latter. Natural frequencies of the Ms group were higher than that of the Ds group, and the response velocity of the Ds group was shorter than that of the Ms group. It is concluded that mechanical vibration analysis is consistent in bones and a correlation between BMD measured by DXA and vibration analysis can be established in young females that may be used in field studies to predict peak bone strength.
Keywords: osteoporosis, BMD, DXA, mechanical vibration, human, tibia, in vivo
Abstract: Falling related injuries are associated with morbidity and mortality among older persons. An accurate and comparable assessment of postural sway may offer a method for detecting those at risk for falling. Our purpose was to assess the validity and repeatability of an inclinometric method in assessing postural sway during quiet standing. To assess repeatability, 51 elderly women (aged 72 to 74 years) were measured twice by the same tester. To assess validity, postural sway in 29 elderly subjects (aged 69 to 86 years) was assessed using simultaneously the inclinometric and a force platform method. The test-retest reliability correlation of the…inclinometric method was high for sway path length (coefficient of determination r2 = 0.683), and moderate for sway area (r2 = 0.500) and the analysis revealed no sign of bias. The correlation was moderate between the values of the inclinometric sway path length and those of the force platform for antero-posterior (r2 = 0.466), lateral (r2 = 0.694) and combined lateral and antero-posterior (r2 = 0.623) directional sway movements. The inclinometric method offers an accurate and repeatable method for assessing postural sway and may be a feasible method to be used in the risk stratification of falling.
Abstract: Introduction: Computer related musculoskeletal disorders affect millions of computer users yearly in developed nations as reported in the literature. With proliferation of computer systems in the developing nations, the associated musculoskeletal pain has yet to be investigated. This serves as impetus for this study. Methods: A structured questionnaire was used to obtain information from computer users across six federal university campuses in Nigeria. The questionnaire contained two sections of 35 items each? The questions requested the respondents to provide information on age, sex, years of computer usage, hour spent on computer per week, associated musculoskeletal pain, pain severity…and knowledge of preventive measures. 1041 questionnaires were analyzed using descriptive statistics. Result: Low back pain and neck pain were found to be the highest pain complaint with 74% and 73% respectively. 67% of the respondents complained of wrist pain, followed by finger pain (65%), shoulder pain 63% and general body pain 61%. The knee and foot pains were the least reported complaints with 26% and 25% respectively. In terms of pain severity, low back pain, finger pain, neck pain and shoulder pain are rated to be moderate, while all other joints were said to be of mild pain. Discussion: The results of this study indicated that low back pain, neck pain and upper limbs are the common disorders complaints among the users. The cause of the pain may be attributed to bad ergonomics among the users.
Abstract: The aim of this study is to determine more accurate prediction method between linear and non-linear methods for prediction of babies’ birth weight among maternal demographic characteristics. Three hundred pregnant women were included in the study. Blood glucose level before and after ingestion of glucose load, age, body mass index, % of change in weight during pregnancy, height, gestational age, parity, fetal sex, were collected as independent variables and baby birth weight as dependent variable. In linear regression, least squares estimation method was used to estimate parameters. Non-linear regression method was performed using neural network model with multilayer perceptrons, back…propagation method was preferred as learning algorithm. Coefficient of determination, R2 , of the linear regression equation was found 59.8% and the standard error of the estimate was calculated as 325.69 gr. In non-linear regression method R2 value was also found 59.8% and standard error of estimate was calculated as 320.30 gr. According to the results of the present study, one method is not significantly better than the other. When ‘accuracy in prediction’ is aimed, it is better to use the two methods and compare the results, and then decide on the selection of the favourable method.