Thursday, March 19, 2015

Amazon expands its one-hour delivery service

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March 19, 2015, 10:54 AM

Amazon expands its one-hour delivery service

Amazon Prime Now is now available to consumers in Baltimore and Miami.
Amazon.com Inc. has expanded its Amazon Prime Now service, which launched in December for consumers in Manhattan and later expanded to Brooklyn, to consumers in Baltimore and Miami. Amazon Prime Now offers delivery of goods in as little as one hour to members of Amazon Prime for a fee of $7.99. Consumers place their order through Amazon’s Prime Now mobile app, available for Apple, Android and Amazon mobile devices.
Amazon says it will be expanding Prime Now to other U.S. cities this year.
Prime Now is available to Prime members in 25 ZIP codes in Baltimore and 10 ZIP codes in Miami, with more ZIP codes to come, Amazon says.
Consumers who want to use Prime Now can get delivery from 8 a.m. to 10 p.m. seven days a week. If a customer is OK with waiting two hours, there’s no delivery fee.
“Customers in Manhattan and Brooklyn love Prime Now--it means you can skip a trip to the store and get the items you need delivered right to your door in under an hour,” says Dave Clark, Amazon’s senior vice president of worldwide operations.
The quick delivery service is yet another addition to the growing list of benefits Amazon makes available only to Prime members; consumers pay $99 a year for Prime membership. Amazon added unlimited photo storage to the list of Prime benefits in November. It also offers members streaming of thousands of movies and TV episodes through Prime Instant Video, access to streaming music with Prime Music, early access to some limited-time offers and free book downloads for Kindle owners.
Amazon hasn’t ever said how many Prime members it has, but an estimate released last month by investment firm Macquarie Group says 20% to 25% of U.S. households, or about 40 million, now belong to Prime. It further estimated that 40% to 52% of U.S. households would have Prime memberships within five years.
Amazon is No. 1 in the Internet Retailer 2014 Top 500 Guide.

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Sunday, March 08, 2015

What is sandbox?


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Sandbox

In general, a sandbox is an isolated computing environment used by software developers to test new programming code.

Saturday, March 07, 2015

Deadly Germs May Lurk In Your Doctor's Clothing

Forbes

TECH  1.123 views
Rob Szczerba

Deadly Germs May Lurk In Your Doctor's Clothing

I never go to hospitals, that’s where all the sick people are.”  It’s an old joke that’s based on some ugly truths.  Hospitals and other healthcare facilities are dangerous places that can lead to a large number of hospital acquired infections (HAIs).  According to the Centers for Disease Control and Prevention (CDC), about 1 in every 25 inpatients has an infection related to hospital care.
We all know that one way germs are spread is through unwashed hands.  In a healthcare setting filled with sick patients, these dangers are obviously increased.  The incredibly compelling video below, by Seema Marwaha, illustrates just how easily a healthcare worker can spread germs through the hospital.
So, besides unwashed hands, where else can bacteria and viruses be commonly lurking?  Equipment, furniture – they can be on almost any surface within reach of human hands in a hospital, clinic, or doctor’s office.  For this reason, a lot of attention has been paid (properly) to sterilizing those tools and surfaces, or, as we discussed in a previous column, by using different surface materials such as antimicrobial copper.
But one important area deserves more attention and study.  What about the clothes worn by healthcare workers themselves?  The February 2014 issue of the Infection Control and Hospital Epidemiology journal addresses the issue of contamination of healthcare personnel attire in non-operating room settings.  Co-author Dr. Mark Rupp,  Chief of the Division of Infectious Diseases at the University of Nebraska Medical Center, summed up their recommendations, “White coats, neckties, and wrist watches can become contaminated and may potentially serve as vehicles to carry germs from one patient to another.”
By Unknown photographer [Public domain], via Wikimedia Commons
Do doctor’s coats, neckties, and wrist watches serve as vehicles to transfer deadly germs from one patient to another?  (Image source: Wikimedia Commons)
 
While this idea makes logical sense, Rupp was quick to add an important caveat:  “It is unknown whether white coats and neckties play any real role in transmission of infection.  Until better data are available, hospitals and doctors’ offices should first concentrate on well-known ways to prevent transmission of infection — like hand hygiene, environmental cleaning, and careful attention to insertion and care of invasive devices like vascular catheters.”  Therefore, the authors recommend that the following measures be voluntary, and accompanied by educational programs.
Bare Below the Elbows (BBE):  The article defines BBE as wearing short sleeves, no wristwatch, no jewelry, and no ties during clinical practice.  Their rationale is that while the BBE approach’s effect on preventing infection is unknown, the practice is supported by biological plausibility and is unlikely to cause harm.
What about white coats?:  Many institutions and individual physicians believe that the traditional white coat worn by doctors is symbolically useful, as it conveys to the patient a reassuring sense of professionalism.  For facilities that mandate or strongly recommend use of a white coat, the authors recommend that individuals possess at least two white coats, and that they launder them no less than once a week (or anytime they are visibly soiled).  Alternately, facilities should provide coat hooks so that the clinician can remove their white coat prior to direct patient contact (and avoid contaminating the coat by not placing it on unsterilized surfaces).
Or neckties?  The authors cite a lack of scientific evidence on potential contamination caused by neckties.  But it doesn’t take a large leap in reasoning to conclude that such a commonly worn and infrequently laundered item may be of concern.  Gonzalo Bearman is an infectious disease specialist from Virginia Commonwealth University, Richmond, and he served on the committee that developed the recommendations.  In a USA Today article on the recommendations, he stated: “We’ve not made the definitive link showing someone getting a hospital-acquired infection from the tip of someone’s neck tie, but there’s reason to suspect it could happen.”

While the scientific jury is out on whether these precautions are absolutely necessary, it certainly makes sense to take a “better safe than sorry” approach.
Follow Rob Szczerba on ForbesTwitter (@RJSzczerba)Facebook, andLinkedIn.

Beware Of These 10 Deadly Tech Hazards In Hospitals

Forbes

TECH  6.256 views
Rob Szczerba

Beware Of These 10 Deadly Tech Hazards In Hospitals

Despite a stated mission of saving lives and providing care, hospitals and healthcare facilities can be very dangerous places.  It’s estimated that more than 400,000 people are killed each year due to preventable medical errors, which include preventable Hospital Acquired Infections (HAIs).  Many of these errors are technology-related, which both clinicians as well as patients need to be aware of.
According to the non-profit ECRI Institute, health technology hazards can come in many forms.  “They can be the result of IT-related problems such as improperly configured systems, incomplete data, or inappropriate malware protection.  They can be caused by inappropriate human-device interaction, such as incorrect reprocessing techniques, improper device maintenance, and poor recall management.  They can also be problems that are intrinsic to the devices themselves: ease-of-use issues, design flaws, quality issues, and failure of devices to perform as they should can all contribute to device-related events.”
By Walleigh (Own work) [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons
With the increasing use of advanced technology in hospitals comes an increasing risk of harm from misuse.  (Image source: Walleigh via Wikimedia Commons)
 
ECRI offered the following list of 10 technology hazards for 2015 that they feel are the most dangerous to the unsuspecting patient.  They also indicate that the list below is not comprehensive, nor will all of the hazards on the list apply to all healthcare facilities.  However it is intended to be a tool that healthcare facilities can use to prioritize their patient safety efforts.
1) Alarm Hazards: Inadequate Alarm Configuration Policies and Practices:  Hospital rooms are typically filled with patient-monitoring devices that emit alarms when pre-set conditions occur.  Frequently, this can make for such an ever-present cacophony of beeps and buzzes that healthcare workers stop paying attention to them.  “Alarm fatigue” will persist unless the facility creates and follows a policy where each piece of equipment is calibrated to sound an alarm only in clinically significant conditions that require a staff response.  An earlier Forbes article expands on this important topic.
2) Data Integrity: Incorrect or Missing Data in EHRs and Other Health IT Systems:  Part of the purpose of electronic health records (EHRs) is to reduce medical errors caused by missing, conflicting, or incorrect information about a patient and their treatment.  But even the most up-to-date technology for centralizing that data is subject to errors by the person entering the information, delays in transmission, or problems as mundane as two computers or pieces of equipment with conflicting date or time readings.
3) Mix-Up of IV Lines Leading to Misadministration of Drugs and Solutions:  It’s common for one patient to be connected to multiple IVs.  A tangle of tubes can result in one or more line being connected to a wrong fluid container, dripping at the wrong rate, or administering medication at the wrong site.  Most errors of this type can be prevented with proper labeling and by physically checking each line from source to destination.
4) Inadequate Reprocessing of Endoscopes and Surgical Instruments:  The Ebola crisis has highlighted the need to carefully disinfect and sterilize any and all objects that have a chance of being contaminated through contact with a patient.  The incidence of problems is low, but the results can be severe.  Endoscopes present a particular challenge because of their narrow, hard-to-clean channels.  Education, rigorous protocols, and adequate time and room for reprocessing are the keys to preventing these errors.
5) Ventilator Disconnections Not Caught because of Miss-set or Missed Alarms:  The aforementioned risks from misconfiguring medical equipment alarms are particularly dangerous in the context of catching ventilators that are experiencing partial or complete disconnection along the breathing circuit.  This can lead to brain injury or death.  Protocols must be enforced to ensure alarms are set to actionable levels, are clearly audible to staff, and are backed up with ancillary notification systems.
6) Patient-Handling Device Use Errors and Device Failures:  Patient-handling refers to healthcare workers lifting, moving, or transferring patients.  A report by the Occupational Safety and Health Administration (OSHA) estimates that in a national survey covering approximately 1,000 hospitals, patient-handling injuries accounted for 25% of all Workers’ Compensation claims for the healthcare industry in 2011.  A wide variety of devices, such as lifts, sliding boards, and specially designed chairs, toilets, mattresses, and stretchers can reduce the strain on workers. But these devices carry their own risks in cases of improper use or mechanical failure.  Regular maintenance of the equipment, training in its proper use, and paying attention to weight-bearing limits are among the best solutions here.
7) “Dose Creep”: Unnoticed Variations in Diagnostic Radiation Exposures:  Patients may be exposed to increased radiation levels by clinicians attempting to improve image quality in diagnostic radiology.  Standard practice requires that the technician obtain the diagnostic image with a dose that is “as low as reasonably achievable (ALARA).”  Manufacturers are increasingly adopting the standardized exposure index (EI), established by the International Electrotechnical Commission (IEC).  Procurement of new equipment that adheres to this standard can eliminate this problem, but only with accompanying software upgrades, device calibration, staff training, and integration of EI checks into existing workflows.
 8) Robotic Surgery: Complications Due to Insufficient Training:  The differences between traditional surgery performed with human hands and robotic surgery performed with machines require training for the entire surgical staff.  This can prevent errors in positioning team members (relative to the size of the robot), lapses in safety precautions and team communication, or a lack of proficiency in the surgeon’s ability to use the equipment optimally.  Training should be reinforced by frequent experience using the robotic equipment, as well as rigorous credentialing.
 9) Cybersecurity: Insufficient Protections for Medical Devices and Systems:  Electronic medical equipment is increasingly interconnected and networked.  That means it is vulnerable to malicious hacks, malware, or invasions of privacy.  These risks should be formally assessed on an ongoing basis, and mitigated through the implementation of IT best practices such as network firewalls, strong passwords, and software patches.
 10) Overwhelmed Recall and Safety-Alert Management Programs: The exponential growth of healthcare technology corresponds to an increasing flow of manufacturer recalls and safety alerts from government agencies and non-profit organizations.  Missed recall or safety announcements aren’t mere administrative errors – they can lead to dangerous malfunctions that endanger patients’ health and lives.  A management system is needed to receive these critical pieces of information, distribute them to the correct personnel, respond to them, and document that response.

For healthcare administrators, clinicians and patients, it’s vitally important to recognize these types of hazards and address them before they cause preventable injury and death.
Follow Rob Szczerba on ForbesTwitter (@RJSzczerba)Facebook, andLinkedIn.

Study Suggests Wi-Fi Exposure More Dangerous To Kids Than Previously Thought !!!

Forbes

TECH  255.458 views
Rob Szczerba

Study Suggests Wi-Fi Exposure More Dangerous To Kids Than Previously Thought

Most parents would be concerned if their children had significant exposure to lead, chloroform, gasoline fumes, or the pesticide DDT.  The International Agency for Research on Cancer (IRIC), part of the United Nations’ World Health Organization (WHO), classifies these and more than 250 other agents as Class 2B Carcinogens – possibly carcinogenic to humans.  Another entry on that same list is radiofrequency electromagnetic fields (RF/EMF).  The main sources of RF/EMF are radios, televisions, microwave ovens, cell phones, and Wi-Fi devices.
Uh-oh. Not another diatribe about the dangers of our modern communication systems?  Obviously, these devices and the resulting fields are extremely (and increasingly) common in modern society.  Even if we want to, we can’t eliminate our exposure, or our children’s, to RF/EMF.  But, we may need to limit that exposure, when possible.
That was among the conclusions of a survey article published in the Journal of Microscopy and Ultrastructure entitled “Why children absorb more microwave radiation than adults: The consequences.”  From an analysis of others studies, the authors argue that children and adolescents are at considerable risk from devices that radiate microwaves (and that adults are at a lower, but still significant, risk).  The following points were offered for consideration:
  • Children absorb a greater amount of microwave radiation than adults.
  • Fetuses are even more vulnerable than children.  Therefore pregnant women should avoid exposing their fetus to microwave radiation.
  • Adolescent girls and women should not place cellphones in their bras or in hijabs (headscarf).
  • Cellphone manual warnings make clear an overexposure problem exists.
  • Government warnings have been issued but most of the public are unaware of such warnings.
  • Current exposure limits are inadequate and should be revised.
  • Wireless devices are radio transmitters, not toys.  Selling toys that use them should be monitored more closely.
Children and fetuses absorb more microwave radiation, according to the authors, because their bodies are relatively smaller, their skulls are thinner, and their brain tissue is more absorbent.
Ipad: By Intel Free Press [CC BY-SA 2.0 (http://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons
Do the benefits of immersive learning applications outweigh the dangers of increased cellular and Wi-Fi exposure for children?  (Image credit: Intel Free Press via Wikipedia)
 
More generally, the studies cited in the paper seek to link RF/EMF exposure to different types of cancer, low sperm count, and other disorders.  However, it is important to note that survey articles such as these need to be taken in their proper context.  This particular article is one group’s perspective.  It was published in a relatively new and minor journal with limited data sets.  They also note that the average time between exposure to a carcinogen and a resultant tumor is three or more decades, thus making it difficult to arrive at definitive conclusions.
This is not a call to throw out all electronic devices.  However, at the very least, it should open up the discussion about different safety levels for adults versus children.  Hopefully more longitudinal studies will be done to verify or contradict the assumptions so far.  In the meantime, are the government’s current regulations adequate?  The exposure levels they warn against haven’t seem to have been updated for more than 19 years.
In a Network World opinion article ominously titled “Is Wi-Fi killing us…slowly?” columnist Mark Gibbs makes the point that “… laws and warnings are all very well but it’s pretty much certain that all restrictions on products that use microwave technology will err on the safe side; that is, the side that’s safe for industry, not the side of what’s safe for society.”  Gibbs then added this ominous closing question, “Will we look back (sadly) in fifty or a hundred years and marvel at how Wi-Fi and cellphones were responsible for the biggest health crisis in human history?”

But, short of that worst-case scenario, the topic certainly merits more scrutiny, and perhaps some common sense limits on what devices our children use, and for how long.

Follow Rob Szczerba on ForbesTwitter (@RJSzczerba)Facebook, andLinkedIn.