scholarly journals Do-It-Yourself Medical Devices: exploring their potential futures through design fiction

2018 ◽  
Author(s):  
Michael Stead ◽  
◽  
Paul Coulton ◽  
Joseph Lindley
Keyword(s):  
Medical Devices ◽  
Do It Yourself ◽  
Design Fiction

scholarly journals Prescribing unapproved medical devices? The case of DIY artificial pancreas systems

2021 ◽  
pp. 096853322199751
Author(s):  
Joseph TF Roberts ◽  
Victoria Moore ◽  
Muireann Quigley
Keyword(s):  
Medical Devices ◽  
Artificial Pancreas ◽  
General Medical Council ◽  
Medical Council ◽  
The United Kingdom ◽  
Slow Progress ◽  
Do It Yourself ◽  
The Uk ◽  
Professional Guidance

In response to slow progress regarding technological innovations to manage type 1 diabetes, some patients have created unregulated do-it-yourself artificial pancreas systems (DIY APS). Yet both in the United Kingdom (UK) and internationally, there is an almost complete lack of specific guidance – legal, regulatory, or ethical – for clinicians caring for DIY APS users. Uncertainty regarding their professional obligations has led to them being cautious about discussing DIY APS with patients, let alone recommending or prescribing them. In this article, we argue that this approach threatens to undermine trust and transparency. Analysing the professional guidance from the UK regulator – the General Medical Council – we demonstrate that nothing within it ought to be interpreted as precluding clinicians from initiating discussions about DIY APS. Moreover, in some circumstances, it may require that clinicians do so. We also argue that the guidance does not preclude clinicians from prescribing such unapproved medical devices.

scholarly journals Patient-Driven Diabetes Technologies: Sentiment and Personas of the #WeAreNotWaiting and #OpenAPS Movements

2020 ◽  
Vol 14 (6) ◽  
pp. 990-999
Author(s):  
Michelle L. Litchman ◽  
Heather R. Walker ◽  
Caroline Fitzgerald ◽  
Mariana Gomez Hoyos ◽  
Dana Lewis ◽  
...  
Keyword(s):  
Medical Devices ◽  
Fast Moving ◽  
Healthcare Providers ◽  
Visual Representations ◽  
Twitter Data ◽  
Multiple Method ◽  
Patients With Diabetes ◽  
Do It Yourself ◽  
Changes Over Time ◽  
Over Time

Background: Patients with diabetes have developed innovative do-it-yourself (DIY) methods for adapting existing medical devices to better fit individual needs. Method: A multiple method study used Symplur Analytics to analyze aggregated Twitter data of #WeAreNotWaiting and #OpenAPS tweets between 2014 and 2017 to examine DIY patient-led innovation. Conversation sentiment was examined between diabetes stakeholders to determine changes over time. Two hundred of the most shared photos were analyzed to understand visual representations of DIY patient-led innovations. Finally, discourse analysis was used to identify the personas who engage in DIY patient-led diabetes technologies activities and conversations on Twitter. Results: A total of 7886 participants who generated 46 578 tweets were included. Sentiment analysis showed that 82%-85% of interactions around DIY patient-led innovation was positive among patient/caregiver and physician groups. Through photo analysis, five content themes emerged: (1) disseminating media and conference coverage, (2) showcasing devices, (3) celebrating connections, (4) providing instructions, and (5) celebrating accomplishments. Six personas emerged across the overlapping userbase: (1) fearless leaders, (2) loopers living it up, (3) parents on a mission, (4) the tech titans, (5) movement supporters, and (6) healthcare provider advocates. Personas had varying goals and behaviors within the community. Conclusions: #WeAreNotWaiting and #OpenAPS on Twitter reveal a fast-moving patient-led movement focused on DIY patient innovation that is further mobilized by an expanding and diverse userbase. Further research is indicated to bring technology savvy persons with diabetes into conversation with healthcare providers and researchers alike.

„Do it yourself“ (DIY) Automated Insulin Delivery (AID) Systems: Stand der Dinge

2019 ◽  
Vol 14 (01) ◽  
pp. 31-43 ◽  
Author(s):  
Lutz Heinemann ◽  
Karin Lange
Keyword(s):  
Type 1 Diabetes ◽  
Medical Devices ◽  
Insulin Delivery ◽  
Point Of View ◽  
Current Status ◽  
Experimental Systems ◽  
Legal Questions ◽  
Medical Devices Act ◽  
Do It Yourself

AbstractOver the past few years, a group of dedicated people with an affinity for technology and type 1 diabetes has developed systems that enable automated insulin delivery (AID). Patients build these AID systems themselves (do it yourself; DIY). The quality of glucose control achieved with DIY AID systems is impressively good, but the effort for users in everyday life is considerable. So far, no results of clinical studies have been obtained that prove these individual experiences.Main obstacles for the use (also by more patients) are legal questions, because DIY AID systems do not represent approved medical devices. They must be regarded as “experimental” systems. As long as patients build and use these systems for themselves and do not endanger other people, they act at their own risk. Legal questions are more complex and more difficult to answer if, for example, a traffic accident occurs. A legal assessment (in particular of the medical situation) of such systems, initiated by the German Diabetes Society (DDG) (see DDG homepage), comes to the following key statements:– From the patient’s point of view, the assembly of a DIY AID system does not constitute a criminal offence. However, since the intended purpose of the devices is violated, there is no liability on the part of the manufacturers of the medical devices used for this purpose.– Patients who assemble DIY AID systems and “sell” them to other patients are liable to prosecution under the Medical Devices Act (MPG).– Doctors do not have to refer patients with type 1 diabetes to DIY AID systems.If a patient expresses interest in such a system or is already using it, the attending physician must inform the patient about the improper use of the medical devices used and about the associated risks. He should document this information accordingly.This overview presents the current status of this development from various points of view.

Ultrastructural changes in murine lymphoma cells exposed to ultraviolet-A radiation

1991 ◽  
Vol 49 ◽  
pp. 104-105
Author(s):  
Delma P. Thomas ◽  
Dianne E. Godar
Keyword(s):  
Medical Devices ◽  
Blood Cells ◽  
White Blood Cells ◽  
Consumer Products ◽  
Ultrastructural Changes ◽  
Ultraviolet A ◽  
Uv Spectrum ◽  
Lymphoma Cells ◽  
Murine Lymphoma ◽  
Transmission Electron

Ultraviolet radiation (UVR) from all three waveband regions of the UV spectrum, UVA (320-400 nm), UVB (290-320 nm), and UVC (200-290 nm), can be emitted by some medical devices and consumer products. Sunlamps can expose the blood to a considerable amount of UVR, particularly UVA and/or UVB. The percent transmission of each waveband through the epidermis to the dermis, which contains blood, increases in the order of increasing wavelength: UVC (10%) < UVB (20%) < UVA (30%). To investigate the effects of UVR on white blood cells, we chose transmission electron microscopy to examine the ultrastructure changes in L5178Y-R murine lymphoma cells.

Bacterial biofilm behavior in water-supply lines of dental units

1992 ◽  
Vol 50 (1) ◽  
pp. 882-883
Author(s):  
B.D. Tall ◽  
K.S. George ◽  
R. T. Gray ◽  
H.N. Williams
Keyword(s):  
Water Supply ◽  
Medical Devices ◽  
Biofilm Formation ◽  
Bacterial Biofilm

Studies of bacterial behavior in many environments have shown that most organisms attach to surfaces, forming communities of microcolonies called biofilms. In contaminated medical devices, biofilms may serve both as reservoirs and as inocula for the initiation of infections. Recently, there has been much concern about the potential of dental units to transmit infections. Because the mechanisms of biofilm formation are ill-defined, we investigated the behavior and formation of a biofilm associated with tubing leading to the water syringe of a dental unit over a period of 1 month.

Einfluss von multimodaler sportlicher Aktivität auf Kognition und Alltagskompetenzen bei früher Alzheimer-Demenz (SPORT&KOG)

2008 ◽  
Vol 21 (3) ◽  
pp. 163-169 ◽  
Author(s):  
J.C. Ennen ◽  
B.W. Mueller ◽  
M. Bibl ◽  
H. Esselmann ◽  
A. Rütten ◽  
...  
Keyword(s):  
Gesundheitsbezogene Lebensqualität ◽  
Sportliche Aktivität ◽  
Depressive Symptome ◽  
Alzheimer Demenz ◽  
Kognitive Entwicklung ◽  
Do It Yourself ◽  
Kognitive Leistung

Der vorliegende Bericht beschreibt ein vom Bundesministerium für Gesundheit gefördertes Vorhaben zum «Leuchtturmprojekt Demenz» im Themenfeld 1 «Therapie und Pflegemaßnahmen: Wirksamkeit unter Alltagsbedingungen». Hierbei handelt es sich um eine multizentrische randomisierte Interventionsstudie, die den Einfluss von Sport (multimodale sportliche Aktivität) unter kontrollierten Bedingungen auf die kognitive Entwicklung von Alzheimer-Patienten im frühen Stadium prüft. In einem zweiarmigen Design werden je 150 Patienten mit früher AD unter Verum- bzw. Kontroll-Bedingungen untersucht. Die Verum-Gruppe erhält ein spezifisches sportliches Trainingsprogramm. In der Kontrollgruppe werden lediglich Dehnungsübungen durchgeführt. Primäre Endpunkte der Studie sind die kognitive Leistung der Patienten sowie deren Alltagskompetenz im Verlauf. Die gesundheitsbezogene Lebensqualität der Patienten sowie etwaige Verhaltensstörungen und depressive Symptome werden als sekundäre Endpunkte erfasst. Darüber hinaus werden die Angehörigen zur krankheitsbezogenen Belastung befragt und auf depressive Symptome untersucht. Angelehnt an die Hypothesen der «Initiative Demenzversorgung in der Allgemeinmedizin» (IDA) sollen entsprechende nicht-medikamentöse Versorgungsangebote dazu beitragen, dass Patienten länger in ihrem gewohnten häuslichen Umfeld leben. Im Sinne der Nachhaltigkeit der zu erwartenden Ergebnisse wird ein «Do it yourself»-Manual erstellt, mit dem das Trainingsprogramm auch ohne professionelle Anleitung, z. B. im Rahmen von Selbsthilfegruppen durchgeführt werden kann. Die weitere Implementierung (z. B. in Internetforen und weiteren Medien) wird durch einen Beirat der lokalen Krankenkassen, Gesundheitsämter und der Deutschen Alzheimer-Gesellschaft unterstützt.

The Complete Do-It-Yourself Guide to SPSS 14.0

PsycCRITIQUES ◽  
2007 ◽  
Vol 52 (16) ◽  
Author(s):  
Sharon Homan
Keyword(s):  
Do It Yourself
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