Putting medical devices in context: a systematic review of evidence on design targeting low-resource settings

Most medical devices are inaccessible to healthcare facilities in low-resource settings (LRSs), severely limiting medical care for a vast proportion of the world's population. This article characterises the process used for designing medical devices for LRSs and investigate how the context-of-use is integrated into the process. A systematic review of 64 papers was conducted to identify peer-reviewed studies of devices intended for LRSs. Using the biodesign process as an analytic framework, a qualitative meta-analysis was conducted. Findings show the studies predominantly describe the later stages of medical device design, whilst largely neglecting how knowledge of the context is considered. To support engineers and improve outcomes, it is imperative that an understanding of the context is integrated throughout the design and product development process. This article highlights this gap and hopes to stimulate research into how context can be better incorporated into the design process for medical devices targeting those populations most in need.This is the author accepted manuscript. The final version is available from Inderscience Publishers via http://dx.doi.org/10.1504/IJDE.2015.07637

Human Movement Control

Control theory is used to design automatic systems, which are able to maintain a desired behaviour despite of the disturbances. It is present in different machines we use every day; in fact, technical systems in our homes and all the industries are hard to imagine today without these concepts. Moreover, the same theories can be used for modelling life processes as a collection of inputs, outputs, plants and control loops. Feedback is one of the main concepts behind control; in particular, several examples of physiological control mechanisms for regulating life aspects can be found in the human anatomy, for example, blood pressure, cholesterol levels, body movements, the equilibrium, etc. Those processes can be damaged by the aging effects, diseases, accidents or when the mechanism has been broken and cannot be recovered naturally; consequently, it will be required external assistance. A relative new field in control theory is related with developing technology for helping with physiological and medicals problems. However, in comparison with machines, those physiological processes are highly nonlinear, with delays and slow responses. Another problem is when human becomes the operators using their capacities of decision making to close the control loop, as they are prone to errors and mistakes. For those reasons, the biomedical system needs to be carefully designed and several aspects have to be considered. This chapter gives a small review of some internal and external control processes within the human body and discusses how to interact with them for designing biomedical devices. Under this design scheme, a practical application of a smart electric wheelchair for assisting persons with strong disabilities is presented. These assistive robotic systems are in close contact with the user, and thus, it is determinant to have a user-friendly relation between the human and the interface. Therefore, intuitive interfaces were included in the design and an intelligent navigation assistant to guarantee a collision-free path

Unlocking skills in hospitals: better jobs, more care

Enabling less highly-trained hospital workers to play a bigger role could improve jobs for doctors and nurses, save public hospitals nearly $430 million a year and fund treatment for more than 85,000 extra people, argues this report. Overview Hospitals are under pressure. They face rising demand, a squeeze on funding and skills shortages in key areas. They have to change. One problem is that too many health professionals squander their valuable skills on work that other people could do. In most cases, it doesn’t take 15 years of post-school training to provide light sedation for a stable patient having a simple procedure. Nor does it take a three-year degree to help someone bathe or eat. But tradition, professional culture and industrial agreements often dictate that highly-trained health professionals spend their time doing straightforward work. This wastes money, makes professional jobs less rewarding and often does not improve care. There are many ways that hospitals can get a better match between workers and their work. This report looks at three examples. The first is using more nursing assistants to provide basic care to patients. The second is letting specialist nurses do common, low-risk procedures currently done by doctors. The third is employing more assistants to support physiotherapists and occupational therapists. These changes can maintain or improve the safety and quality of care. They are among the easiest to take up. Hospitals don’t have to be reorganised or new professions created. They would save public hospitals$430 million a year. That could fund treatment for more than 85,000 extra people. These ideas are supported by solid evidence. They have been tried successfully in Australia, with good results for patients. Hospital CEOs we surveyed for this report strongly support them. Despite all this, progress is painfully slow. Formidable barriers in the form of regulations, culture, tradition and vested interests stand in the way. We need a new mechanism to overcome these barriers – a way to get from isolated trials to broad change. Creating that mechanism is even more important than the examples in this report. People may disagree with specific examples. But no-one can argue that all hospital work is done by the right person, or that a good way currently exists to get change throughout the system. Two things are needed. Hospitals, regulators and professional bodies must improve rules and regulations. State governments must invest money and expertise in spreading good practices. If we don’t update workforce roles, there will be a cost. Hospitals already struggle to provide enough care. Waiting lists are long and demand is growing fast. It’s hard to keep some hospital workers in their jobs. Government budgets are also under pressure. If action isn’t taken to make hospitals more efficient, tougher decisions about who will miss out on care are inevitable. Current workforce roles were designed in the days of the horse and buggy. The choice to update them should be easy. It means more and better care, more rewarding jobs for hospital professionals and a more sustainable system

Robot-assistive minimally invasive surgery:trends and future directions

The evolution of medical technologies—such as surgical devices and imaging techniques—has transformed all aspects of surgery. A key area of development is robot-assisted minimally invasive surgery (MIS). This review paper provides an overview of the evolution of robotic MIS, from its infancy to our days, and envisioned future challenges. It provides an outlook of breakthrough surgical robotic platforms, their clinical applications, and their evolution over the years. It discusses how the integration of robotic, imaging, and sensing technologies has contributed to create novel surgical platforms that can provide the surgeons with enhanced dexterity, precision, and surgical navigation while reducing the invasiveness and efficacy of the intervention. Finally, this review provides an outlook on the future of robotic MIS discussing opportunities and challenges that the scientific community will have to address in the coming decade. We hope that this review serves to provide a quick and accessible way to introduce the readers to this exciting and fast-evolving area of research, and to inspire future research in this field

Models of Information Systems devoted to Medical Imaging Labs: an experience in the CNR Clinical Physiology Institute

abstract for the paper presentation about the decennal experience at IFC on information systems developped for medical imaging labsabstract per la presentazione relativa alla decennale esperienza presso IFC sui sistemi informativi sviluppati per uso dei laboratori dedicati all\u27imaging clinico e di ricerca medic

Applications of Artificial Intelligence (AI) in healthcare: A review

Artificial intelligence is revolutionizing — and strengthening — modern healthcare through technologies that can predict, grasp, learn, and act, whether it's employed to identify new relationships between genetic codes or to control surgery-assisting robots. It can detect minor patterns that humans would completely overlook. This study explores and discusses the various modern applications of AI in the health sector. Particularly, the study focuses on three most emerging areas of AI-powered healthcare: AI-led drug discovery, clinical trials, and patient care. The findings suggest that pharmaceutical firms have benefited from AI in healthcare by speeding up their drug discovery process and automating target identification. Artificial Intelligence (AI) can help also to eliminate time-consuming data monitoring methods. The findings also indicate that AI-assisted clinical trials are capable of handling massive volumes of data and producing highly accurate results. Medical AI companies develop systems that assist patients at every level. Patients' medical data is also analyzed by clinical intelligence, which provides insights to assist them improve their quality of life

UWOMJ Volume 82, No 2, Fall 2013

Schulich School of Medicine & Dentistryhttps://ir.lib.uwo.ca/uwomj/1068/thumbnail.jp