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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: The causes of arteriosclerosis are intensively investigated since many decades. While circumferential wall stress has received a lot of attention, axial stress (also called “longitudinal” stress) has been largely neglected, and practically never incriminated. However, it has been suggested in 2003 that moderate and severe arterial stenoses may induce non negligible axial forces cyclically in the vessel segment just proximal to the constriction cone. In the present contribution, we describe a simple analytical model that allows to study the distribution of these forces along the vessel in dependence of the respective axial elasticities of vessel and surrounding tissues, and of…the stenosis length.
Abstract: To date, information technology (IT) has not been widely adopted in the health sector in the developing countries. Information Technology may bring an improvement on health care delivery systems. It is one of the prime movers of globalization. Information technology infusion is the degree to which a different information technology tools are integrated into organizational activities. This study aimed to know the degree and the extent of incorporation of Information Technology in the Nigerian health sector and derive an IT infusion models for popular IT indicators that are in use in Nigeria (Personal computers, Mobile phones, and the Internet) and…subsequently investigates their impacts on the health care delivery system in Nigerian teaching hospitals. In this study, data were collected through the use of questionnaires. Also, oral interviews were conducted and subsequently, the data gathered were analyzed. The results of the analysis revealed that out of the three IT indicators considered, mobile phones are spreading fastest. It also revealed that computers and mobile phones are in use in all the teaching hospitals. Finally in this research, IT infusion models were developed for health sector in Nigeria from the data gathered through the questionnaire and oral interview.
Keywords: Information technology, Internet, infusion model
Abstract: There is growing evidence of the use of the Internet to obtain critical health information as well as increased diversity of user groups. While users of web-based information often report their reliance on healthcare providers for validation of information, it has yet to be determined if this is universally true across all types of information or user groups. In some cases consumers may aggregate in places where they trust web information (relative to provider-based information), such as areas of unsettled diagnostic methods or ambiguous treatment protocols. To date little research has been done to identify and differentiate clusters of health…consumers and their similarities related to type of information sought. Data from a study of consumer Web search activity in a post-intervention era serves as a natural experiment, and can identify whether clusters of “digitally underserved groups” persist in the US, following national efforts to eliminate barriers to health information access. This exploratory technology assessment study seeks to differentiate and delineate specific information behaviors, across targeted healthcare subgroups. Doing so allows the design of more effective strategies to promote the use of the Web as a health education and health promotion tool, under the envisioned shared decisionmaking, consumer-centric health information model, critical to the proposed US national health information infrastructure.
Keywords: Web, Internet, digital divide, consumer, health information, digitally underserved group, technology assessment
Abstract: Familiarity with and use of computers is increasingly cited as a limiting factor related to the potential of the Internet as an effective healthcare resource for the elderly. This study sought to examine differences across age groups in their access to and use of computers and the Internet as a health information resource. We perform multivariate analysis with data from a stratified sample of survey-reported health information-seeking behaviors on the Internet. The results suggest that access to online health information among Internet users varies significantly from the use of computers and Internet. Younger participants showed the highest rates in the…use of computer and Internet, and exhibited the lowest rates in the access to online health information. In 2000, 56.7% and 55.9% of medium and older Internet users ever looked for health information on the Web, respectively, whereas 49.4% of young Internet users ever did. By 2002, these fractions had increased by 14.6%, 13.5% and 9.1%, respectively. The comparison of ORs between 2000 and 2002 indicated that the gap is somewhat increased, although the increase was not statistically significant at 0.05 level (the ORs of old to young at 2000 = 1.30 [0.933, 1.817]; the ORs at 2002 = 1.61 [1.157, 2.255]). Findings show that the gap between old and young seekers users of computers and the Internet for information appears to have widened in recent years, even as advocates of consumer-centric healthcare continue to promote the Internet as a key source of empowerment for the elderly.
Keywords: Web, Internet, digital divide, consumer, health information, digitally underserved group
Abstract: Study of cardiac functions has shown to be important in understanding the prognosis and pathogenesis of vascular diseases. A physiologic parameter termed pulse transit time (PTT) has been studied intensively to be used as an indirect marker of such pathologic conditions. It is defined as the time it takes a pressure pulsation to travel between two arterial sites. For convenience of measurement, the interval between the peak of the R-wave on the electrocardiogram and the onset of the corresponding pulse in the finger pad measured by photoplethysmography is usually used. In this review, its definition, current applications in cardiovascular related…studies and issues are presented in turn. Investigational studies suggest that PTT did not meet the level of accuracy required for medical practice as a marker for beat-to-beat blood pressure (BP). However, documented evidences indicate that PTT has high correlations when it is utilised as a surrogate semi-quantitative monitor of abrupt BP changes. Present literature suggests that description of disease-specific cardiovascular reactivity pattern is possible with techniques based on PTT. The attraction of PTT due to its non-invasive nature and revealing properties can only increase. Hence, the use of this simple technique in a clinical setting is still to realise its full potential.
Abstract: Objective: To design and evaluate a novel computer-assisted, fluoroscopy-based planning and navigation system for minimally invasive ventral spondylodesis of thoracolumbar fractures. Materials and Methods: Instruments and an image intensifier are tracked with the SurgiGATE® navigation system (Praxim-Medivision). Two fluoroscopic images, one acquired from anterior-posterior (AP) direction and the other from lateral-medial (LM) direction, are used for the complete procedure of planning and navigation. Both of them are calibrated with a custom-made software to recover their projection geometry and to co-register them to a common patient reference coordinate system, which is established by attaching an opto-electronically trackable dynamic…reference base (DRB) on the operated vertebra. A bi-planar landmark reconstruction method is used to acquire deep-seated anatomical landmarks such that an intraoperative planning of graft bed can be interactively done. Finally, surgical actions such as the placement of the stabilization devices and the formation of the graft bed using a custom-made chisel are visualized to the surgeon by superimposing virtual instrument representations onto the acquired images. The distance between the instrument tip and each wall of the planned graft bed are calculated on the fly and presented to the surgeon so that the surgeon could formalize the graft bed exactly according to his/her plan. Results: Laboratory studies on phantom and on 27 plastic vertebras demonstrate the high precision of the proposed navigation system. Compared with CT-based measurement, a mean error of 1.0 mm with a standard deviation of 0.1 mm was found. Conclusions: The proposed computer assisted, fluoroscopy-based planning and navigation system promises to increase the accuracy and reliability of minimally invasive ventral spondylodesis of thoracolumbar fractures.