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David Yadin , Saide Calil, Nicolas Pallikarakis, Mladen Poluta, Kallirroi Stavrianou, Stefano Bergamasco, Daniel Clark, Tom Judd, James Wear, Tony Easty
Global Clinical Engineering Journal, Volume 3, pp 5-14; doi:10.31354/globalce.v3i2.111

Abstract:
To determine the maturity of a profession one must have knowledge of the individual attributes of the practitioners of that profession and the universal strength of unique skills among them. We have conducted an international survey of Clinical Engineering (CE) professionals associated with the management of technological tools developed for and deployed within the healthcare delivery system. The survey targeted participants who are practicing engineering tasks related to the safe and efficient management of technology used in the delivery of healthcare services. The participants, consisted of cohort of individuals whose contact information was collected from attendees at previous clinical and biomedical engineering events including: (1) presentation at congresses/regional meetings, (2) serving on international technical committees or task forces, (3) attending virtual clinical engineering events, or (4) subscribing to the Global Clinical Engineering Journal. The purpose of the survey was to identify the state of organization of CE professionals and the potential gaps, if any exists, in meeting their professional development needs. The survey was developed and conducted using on-line internet apps and links that provided access to a questionnaire in six different languages to facilitate optimal participation and response accuracy in as many geographical regions as possible. The survey was conducted in the early part of 2020 over period of 6 weeks. The overall response rate1 was over 5% (total of 14,400 individual contacts less estimated 1,750 contacts who did not open/bounced back). A total of 667 responses from 89 countries were received. This survey is considered an improvement, over previously reported international surveys2,3, with regard to response volume and rate. The strength of this survey, having larger response volume and geographical representation, when compared with previously documented CE surveys has improved even with narrower time window of data collection. The current survey consisted of twelve questions, beginning with information request about the respondent professional affiliation and moves on to request the ranking of the criticality of C.E. specific issues, while another question provided for comments in free formatting text style. The responses received were in all of the seven languages posted and included representation from all the continents. The analysis of the survey responses shows that about 60% of the responders identified themselves as clinical engineers, 16% as other type of engineers, 13% as technicians, and 12% as health professionals. Responses to particular questions demonstrate highest ratio of number of affirmative to negative responses. They were related to the perceived value responders placed on stronger international collaboration and on their willingness to engage in it. A conclusion, based on the analysis of the responses to this international survey, that the CE profession is awaiting the consolidation of the momentum generated by growing healthcare needs and present global conditions. The identified gap is lack of a dedicated international representation that is clearly identifiable within the CE field. Analysis of the survey data suggests the need of an international framework focusing on the various CE professional groups/associations and their members to face present challenges. The establishment of a global alliance to clearly identify the field of clinical engineering; to promote public awareness; to form liaison with government agencies and other healthcare decision makers, will improve global cooperation and inter CE societal relations that will serve patients as well.
Global Clinical Engineering Journal, Volume 3, pp 32-37; doi:10.31354/globalce.v3i2.56

Abstract:
This work has as its proposition, to present a project whose main goal is to suggest the establishment of a flow with detailed stages, from the moment that it is defined the discarding of an electro- electronic equipment used in hospital environment until the reuse of possible material to the manufacturing of new equipment. The suggestion is applying to all the equipment electro-electronic used in the hospital (be the biomedical, electro-mechanic in general, computer, refrigerator, air conditioner etc.). And thus contributing to issues socio-environmental, as well as economic – financial, through an appropriated discarding process
Mêtowanou Héribert Ahouandjinou, Daton Medenou, Leandro Pecchia, Roland C. Houessouvo, Thierry Rock Jossou
Global Clinical Engineering Journal, Volume 3, pp 19-31; doi:10.31354/globalce.v3i2.85

Abstract:
Background: Because of the health systems globalization, it is important to examine health systems organization in Africa, in terms of patient care, to highlight the failures and propose possible solutions. Objective: Modeling based on the Internet of Things (IoT) an Integrated Network for Monitoring Patient Data in West African Health Systems. Methodology: To achieve this, three steps have been followed. 1) Identification of the different characteristics of IoT-based health surveillance systems, WBAN systems and physiological parameters monitorable on a patient. 2) The modeling of the architecture of West African health systems in the form of a cloud of Technocentres. 3) Cross analysis between different IoT technologies, characteristics and functional requirements identified. All this is based on wireless medical sensor networks in Wireless Body Area Network (WBAN) systems. Result: This work has been used to model health systems in Africa as a remote monitoring network for patients. Conclusion: The implementation of this model of monitoring networks will be a tool for supporting large-scale decision-making for a health system in Africa. It will enable the West African health system to have an information database.
Global Clinical Engineering Journal, Volume 3, pp 15-18; doi:10.31354/globalce.v3i2.116

Abstract:
Sterile processing errors in medical and dental offices are ranked the third highest hazard according to the annual ECRI ‘Top 10 Health Technology Hazards’ 2020 report. Other experts have raised similar concerns with sterilisation processes. For example, the WHO and the Clinical Engineering Division of International Federation of Medical and Biological Engineering (IFMBE) have partnered to provide a series of webinars with international experts exchanging knowledge on COVID-19 related critical topics. A recent webinar addressed the critical challenge of decontamination and disinfection of COVID-19 medical equipment in low-income and middle-income countries. During the webinar, participants asked about methodologies to assess whether the transmission of infection is borne by technological tools used to fight the disease. How can critical lifesaving breathing equipment be safely and quickly sterilised and moved from one patient to the next? The WHO/IFMBE webinar2 stated that ‘engineers and infection control professionals seem to be working in different silos’. Such silos must be dismantled because medical technology is indispensable in the provisioning of healthcare services. Disinfection and sterilisation of medical equipment are key concerns for healthcare organisations, and they require serious consideration of sociotechnical system interactions. The annual ‘top 10 Health Technology Hazards report’ is based on retrospective studies, yet management of COVID-19 safety requires capacity to process real- time data and the input of experts to predict where risks may occur and how to deploy plans to maintain a safe healthcare environment.
Michael Cheng
Global Clinical Engineering Journal, Volume 3, pp 38-39; doi:10.31354/globalce.v3i2.110

Abstract:
Dear Editor, It is clear that potential COVID pandemics will be recurring events and the use of PPE is basic and vital. Everyone will need such simple devices to protect themselves and others. The consequence of no PPE protection could be disastrous for global health! Stockpiling PPE is not for everyone. Healthcare facilities in low resources countries have limited PPE supplies. Furthermore, transportation and distribution across the country are problems, particularly in rural areas. Home-made PPE is the most practical solution but this needs effective global efforts to educate and guide global populations. In the past 3 months, the IFMBE/CED, in collaboration with WHO and different professionals, has conducted an excellent series of webinars to inform the world about medical devices in combating the Covid-19 pandemic bringing invaluable information for global healthcare. We wonder if IFMBE/CED would pioneer another important initiative to advocate, and together with WHO, to co-ordinate the resources from different organizations and individual professionals to compose a manual on home-made PPE’s with basic knowledge on cleaning and sterilization so that laypersons can make PPE to protect themselves and others. A highly successful public health education publication “Where there is no doctors” [1] is an example. Preventing SARS and other flu disease is a global problem currently relies mainly on isolated and scattered national solutions. It is urgent that international organizations such as IFMBE and WHO provide trusted advice to countries worldwide to create a global protection-sensitive culture against pandemics.
Global Clinical Engineering Journal, Volume 3, pp 1-2; doi:10.31354/globalce.v3i2.115

Marcelo Antunes Marciano , Rodrigo Rezer, Anderson Santos
Global Clinical Engineering Journal, Volume 3, pp 44-49; doi:10.31354/globalce.v3i1.57

Abstract:
Medical equipment that supports life, relieves diseases, and overcomes disabilities can also cause damage and death due to operational failures, user failures, and misuse. Hemodialysis machines include roller pumps that control the flow of blood, and these pumps have to be calibrated accurately to ensure they are working properly. This article describes the development of a low-cost, open source prototype that automates the flow analysis (measurement and recording) of the blood pumps in hemodialysis machines. Being able to accurately inspect the machine’s operation improves the quality and safety of its use. Through this technology (this process automation), it is believed equipment downtime and total tests cost will be reduced. This device has a system that collects data in real time, generated by the blood pump dialysis. Mathematical calculations are used to present flow information, including the standard deviation of the measurement, which is reported at the end of the test in an objective and simple way. Through a software and human machine interface (HMI), the test can be monitored and generate a report that contains the name and model of the equipment, the quantitative results of the flows, and the standard deviations of the measurements. The device can be used by clinical engineering teams in preventive maintenance and after corrective maintenance, as a control practice, making the calibration process easier and more cost-effective.
David Yadin , Jerome Schultz
Global Clinical Engineering Journal, Volume 3, pp 33-43; doi:10.31354/globalce.v3i1.102

Abstract:
This paper describes the guidelines for writing effective manuscript that complies with general scientific writing style and in particular with those that are incorporated by the editors and reviewers of the Global Clinical Engineering Journal (www.GlobalCE.org) when they evaluate submission of manuscripts. Readers of this paper will gain understandings of the manuscript preferred writing format and of the submission’s individual sections. Examples are provided for each of individual sections that further explain their purpose and contrast of their various styles. When the guidance provided in this paper is incorporated into a new submission, it is expected to elevate the quality of the writing as well as the desire of young clinical engineers to publish about their work and the interest of the scientific community to read it.
Rodrigo Mijares, Roberto Moreno, Erika Pedraza, Fernando Morales, Renzo Boccardo, María Antonieta García
Global Clinical Engineering Journal, Volume 3, pp 27-32; doi:10.31354/globalce.v3i1.104

Abstract:
Background and Objective: Venezuela presents a health, socio-economic crisis (minimum wage of 2.32 US dollars monthly), and a political one. Apart from having very poor quality public services and coverage, such as water, public transport, electricity, and the Internet. In this context, COVID-19 appears. This pathology quickly became a pandemic since its transmission occurs mainly through contact with the secretions of infected patients or with contaminated surfaces. Health workers face a higher risk of infection than the rest of the population. For this reason, the objective of the work was to reduce this threat while working with patients with COVID-19, redesigning the original "spray box". To carry out this work, the university, private health providers and private companies had to be united. Material and Methods: The following phases were carried out: a) A sketch is created; b) A 3D CD model is created; c) The prototype is manufactured; d) The prototype is improved; and e) The effectiveness and safety tests are carried out. Results: As a result, the medical team obtained a tool to limit the spread of COVID 19 and thereby improve the health of the health workers involved. This instrument is called "Cube de Vie" (CubeDV). Conclusions: to carry out a job in Venezuela is very complicated under the circumstances it presents, however, the joint work of three organizations such as the university, private health providers and private companies can generate solutions to the serious situation that the pandemic presents. .
Fred Hosea
Global Clinical Engineering Journal, Volume 3, pp 10-26; doi:10.31354/globalce.v3i1.98

Abstract:
GLOBAL DISASTER UNPREPAREDNESS - The global COVID-19 crisis of 2020 has thrown a disturbing spotlight on the many ways in which healthcare systems, governments, medical industries, markets, and healthcare professions have been dangerously fragmented, unprepared, under-resourced, tragically slow and uncoordinated in responding to the most disruptive medical disaster of our times. Despite numerous threat-analysis studies, detailed pandemic scenarios and simulations by state and Federal agencies, despite billions of dollars spent on post-9/11 international disaster preparedness, and repeated top-levels warnings, the world’s governments, markets and healthcare systems have failed to prepare and prevent a health disaster from exploding into a multi-dimensional catastrophe. The fragmentation of plans and competencies across sectors, complicated by political decision-making, clearly demand mission-critical re-organization among the institutional players, with more coordinated, integrated, and systems-oriented professional approaches worldwide, and active cultivation of public health intelligence. For the reasons that follow, Clinical and Biomedical Engineers are among the best-suited health professionals to assume an expanded and comprehensive leadership role in this urgently needed transformation.
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