Lost in translation? : negotiating technological innovation in healthcare

Technological innovation in healthcare is growing at a rapid pace. Developments in genetics, stem cell research, bioinformatics, imaging and screening techniques have broadened out the arena of health technology. These developments in sophisticated technology, it is suggested, have the potential to revolutionize the practices of medicine and healthcare by providing more proactive and powerful tools for the diagnosis, treatment, and prevention of illness and disease (Liddell et al, 2008; Webster, 2002). In support of such claims, available research findings suggest that the adoption of new innovative health technologies (IHTs) can result in reducing healthcare costs, increasing productivity, healthcare effectiveness, and improving the patient’s experience of care by better management of chronic diseases (Liddell et al, 2008; Healthcare Industries Task Force, 2004). At the same time, new innovative health technologies present many challenges. Evidence indicates that patient safety and proven clinical effectiveness are insufficient to ensure the adoption and implementation of new clinical technologies. The prevailing organizational and policy context is crucially important as this may present barriers which slow or even prevent uptake (Lehoux 2006). In recent years there has been a continuing debate around issues of clinical resistance, organizational/clinical restructuring, procurement and commissioning, public trust, and, more widely, around the ethical and social implications of techno-scientific innovations in medicine and health (Williams and Dickinson, 2008; Webster, 2006; Ferlie et al., 2005). Moreover, cost-effectiveness evidence is now required to inform decisions about the funding and procurement of new healthcare services and technologies (Fitzgerald et al., 2002). Overall, the value of the innovation has to be clearly evident to a number of different stakeholders if technologies are to be embedded into actual work practices. These potential barriers have given rise to questions related to the diffusion and adoption of emerging medical and healthcare innovations. This paper examines the dynamics and complexity of innovation adoption processes in the context of a rapidly changing healthcare policy landscape. Drawing upon the inherently socially negotiated character of meaning, this paper illustrates the ambivalent nature of technological innovation by examining the complex ongoing interplay of heterogeneous discourses in shaping the adoption of innovative health technologies (Law, 1987, 1994). Drawing upon Rye and Kimberly (2007) adoption is here understood as a distinct organizational process related to an organization’s potential interest in implementing a technological innovation. In so doing, this paper draws on the findings of a three year research project which examines the adoption of innovative clinical technologies in the UK NHS. In particular, we explore the nature, role and dynamics of heterogeneous discourses (technological, managerial/professional, clinical), in shaping the adoption of a retinal imaging technology in a UK hospital Trust. In this regard, we contribute to the development of alternative ways of describing, analysing, and theorizing the process of technological innovation in healthcare

Project LOCOST: Laser or Chemical Hybrid Orbital Space Transport

A potential mission in the late 1990s is the servicing of spacecraft assets located in GEO. The Geosynchronous Operations Support Center (GeoShack) will be supported by a space transfer vehicle based at the Space Station (SS). The vehicle will transport cargo between the SS and the GeoShack. A proposed unmanned, laser or chemical hybrid orbital space transfer vehicle (LOCOST) can be used to efficiently transfer cargo between the two orbits. A preliminary design shows that an unmanned, laser/chemical hybrid vehicle results in the fuel savings needed while still providing fast trip times. The LOCOST vehicle receives a 12 MW laser beam from one Earth orbiting, solar pumped, iodide Laser Power Station (LPS). Two Energy Relay Units (ERU) provide laser beam support during periods of line-of-sight blockage by the Earth. The baseline mission specifies a 13 day round trip transfer time. The ship's configuration consist of an optical train, one hydrogen laser engine, two chemical engines, a 18 m by 29 m box truss, a mission-flexible payload module, and propellant tanks. Overall vehicle dry mass is 8,000 kg. Outbound cargo mass is 20,000 kg, and inbound cargo mass is 6,000 kg. The baseline mission needs 93,000 kg of propellants to complete the scenario. Fully fueled, outbound mission mass is 121,000 kg. A regeneratively cooled, single plasma, laser engine design producing a maximum of 768 N of thrust is utilized along with two traditional chemical engines. The payload module is designed to hold 40,000 kg of cargo, though the baseline mission specifies less. A proposed design of a laser/chemical hybrid vehicle provides a trip time and propellant efficient means to transport cargo from the SS to a GeoShack. Its unique, hybrid propulsion system provides safety through redundancy, allows baseline missions to be efficiently executed, while still allowing for the possibility of larger cargo transfers

Conversaciones virtuales: Investigación y práctica en los intercambios de lengua en línea

Advances in digital technology have created interesting opportunities for language learners to engage in conversation with native speakers. These opportunities provide the possibility for tremendous growth in language and culture learning (Lewis & O’Dowd, 2016) in ways that until recently did not exist. These interactions can take a variety of forms. Some instructors create highly controlled interactions with specific activities and pre-assigned partners. Others students are asked to connect to social media style sites where they experience enormous autonomy in choosing when they interact, who they interact with, and what they speak about (Malerba, 2012). Online exchanges with native speakers also vary according to the linguistic competence of the speakers. Generally, online exchanges have been used with learners who are at intermediate or advanced skill levels. However, the present study builds on recent research suggesting that even novice level learners can benefit from interacting with native speakers online (Satar & Özdener, 2008; Schenker, 2017). In this study, the authors examined novice students’ perceptions of learning and changes in comfort level after participating in a series of online and in-person exchanges over the course of a semester. The study compared students’ perceptions of online interactions generally with those of in-person exchanges and also compared the results of the use of various services. Results suggest that students in all of the groups, online and in-person, felt more comfortable interacting with native speakers and felt that they improved their language skills by engaging in these activities. With that said, students in the in-person group tended to feel more comfortable speaking with native speakers, but students in most of the online groups felt that the one on one nature of the interactions in the online settings led to the most growth.Los avances en la tecnología digital han creado oportunidades interesantes para que los estudiantes de lengua participen en conversaciones con hablantes nativos. Estas oportunidades brindan la posibilidad de un enorme crecimiento en el aprendizaje de lenguas y culturas (Lewis & O’Dowd, 2016) en formas que hasta hace poco no existían. Estas interacciones pueden tomar una variedad de formas. Algunos instructores crean interacciones sumamente controladas con actividades específicas y compañeros asignados previamente. A otros estudiantes se les pide que se conecten a sitios al estilo de las redes sociales donde experimentan una enorme autonomía para elegir cuándo interactúan, con quién interactúan y de qué hablan (Malerba, 2012). Los intercambios en línea con hablantes nativos también varían de acuerdo con la competencia lingüística de los hablantes. En general, los intercambios en línea se han utilizado con estudiantes que se encuentran en los niveles intermedios o avanzados. Sin embargo, el presente estudio se basa en investigaciones recientes que sugieren que incluso los principiantes de nivel principiante pueden beneficiarse de la interacción en línea con hablantes nativos (Satar & Özdener, 2008; Schenker, 2017). En este estudio, los autores examinaron las percepciones de los estudiantes principiantes sobre el aprendizaje y los cambios en el nivel de comodidad después de participar en una serie de intercambios en línea y en persona en el transcurso de un semestre. El estudio comparó las percepciones de los estudiantes sobre las interacciones en línea en general con las de los intercambios en persona y también comparó los resultados del uso de diversos servicios. Los resultados sugieren que los estudiantes de todos los grupos, en línea y en persona, se sintieron más cómodos interactuando con hablantes nativos y sintieron que mejoraron sus habilidades lingüísticas al participar en estas actividades. Dicho esto, los estudiantes en el grupo en persona tienden a sentirse más cómodos al hablar con hablantes nativos, pero los estudiantes, en la mayoría de los grupos en línea, sintieron que la naturaleza de las interacciones en línea de hablar uno a uno condujo a un mayor crecimiento

Species abundance information improves sequence taxonomy classification accuracy.

Popular naive Bayes taxonomic classifiers for amplicon sequences assume that all species in the reference database are equally likely to be observed. We demonstrate that classification accuracy degrades linearly with the degree to which that assumption is violated, and in practice it is always violated. By incorporating environment-specific taxonomic abundance information, we demonstrate a significant increase in the species-level classification accuracy across common sample types. At the species level, overall average error rates decline from 25% to 14%, which is favourably comparable to the error rates that existing classifiers achieve at the genus level (16%). Our findings indicate that for most practical purposes, the assumption that reference species are equally likely to be observed is untenable. q2-clawback provides a straightforward alternative for samples from common environments

Spontaneous Vesicle Formation in a Deep Eutectic Solvent

Solvent penetration experiments and small-angle X-ray scattering reveal that phospholipids dissolved in a deep eutectic solvent (DES) spontaneously self-assemble into vesicles above the lipid chain melting temperature. This means DESs are one of the few nonaqueous solvents that mediate amphiphile self-assembly, joining a select set of H-bonding molecular solvents and ionic liquids.Australian Research Counci

Keemei: cloud-based validation of tabular bioinformatics file formats in Google Sheets.

BackgroundBioinformatics software often requires human-generated tabular text files as input and has specific requirements for how those data are formatted. Users frequently manage these data in spreadsheet programs, which is convenient for researchers who are compiling the requisite information because the spreadsheet programs can easily be used on different platforms including laptops and tablets, and because they provide a familiar interface. It is increasingly common for many different researchers to be involved in compiling these data, including study coordinators, clinicians, lab technicians and bioinformaticians. As a result, many research groups are shifting toward using cloud-based spreadsheet programs, such as Google Sheets, which support the concurrent editing of a single spreadsheet by different users working on different platforms. Most of the researchers who enter data are not familiar with the formatting requirements of the bioinformatics programs that will be used, so validating and correcting file formats is often a bottleneck prior to beginning bioinformatics analysis.Main textWe present Keemei, a Google Sheets Add-on, for validating tabular files used in bioinformatics analyses. Keemei is available free of charge from Google's Chrome Web Store. Keemei can be installed and run on any web browser supported by Google Sheets. Keemei currently supports the validation of two widely used tabular bioinformatics formats, the Quantitative Insights into Microbial Ecology (QIIME) sample metadata mapping file format and the Spatially Referenced Genetic Data (SRGD) format, but is designed to easily support the addition of others.ConclusionsKeemei will save researchers time and frustration by providing a convenient interface for tabular bioinformatics file format validation. By allowing everyone involved with data entry for a project to easily validate their data, it will reduce the validation and formatting bottlenecks that are commonly encountered when human-generated data files are first used with a bioinformatics system. Simplifying the validation of essential tabular data files, such as sample metadata, will reduce common errors and thereby improve the quality and reliability of research outcomes

Digital Connections: Student Experiences in Online Language Exchanges

Exciting advances in technology have provided foreign language teachers with opportunities to connect students to native speakers of target languages. Much of the research in this area focuses on changes in proficiency or cultural sensitivity. Although valuable, the research is lacking in understanding students’ experiences online, including positive and negative feelings, challenges, as well as students’ overall opinions of the exchanges’ usefulness for learning. The present study used a mixed methods approach to examine the experiences of third-semester university students participating in online language exchanges with native speakers. A third-semester Spanish class at a large university consisting of 18 students was selected as a sample. Students were required to speak online with native Spanish speakers in the target language for 20 minutes each week. Students completed weekly surveys and a final survey, and three students were selected for semi-structured interviews. The data reveal common struggles that students face during online exchanges, methods students use for coping with these difficulties, areas of perceived growth, and social factors that affect students’ experiences. The article concludes with recommendations for what foreign language educators can do to support students in similar online exchanges

Inside a Digital Experiment: Co-producing Telecare Services for Older People

The problem of the user remains central to information systems research and practice, more so given the importance now given to user-led innovation. Telecare is a much-vaunted example of e-enabled health and social care which, over the past decade or more has received considerable policy attention and investment in Europe and beyond. However, it appears that the technological opportunities offered have not been taken-up in everyday practice and that the engagement of users—service providers and end users—has been identified as a major barrier. This article presents the experience of a European level project that sought to use a form of co-production to engage users in the development of a telecare system for older people. The outcome was a platform with infrastructural properties and a service-orientated architecture better able to support subsequent innovation in use