Stakeholder challenges in purchasing medical devices for patient safety.

OBJECTIVE: This study identifies the stakeholders who have a role in medical device purchasing within the wider system of health-care delivery and reports on their particular challenges to promote patient safety during purchasing decisions. METHODS: Data was collected through observational work, participatory workshops, and semi-structured qualitative interviews, which were analyzed and coded. The study takes a systems-based and engineering design approach to the study. Five hospitals took part in this study, and the participants included maintenance, training, clinical end-users, finance, and risk departments. RESULTS: The main stakeholders for purchasing were identified to be staff from clinical engineering (Maintenance), device users (Clinical), device trainers (Training), and clinical governance for analyzing incidents involving devices (Risk). These stakeholders display varied characteristics in terms of interpretation of their own roles, competencies for selecting devices, awareness and use of resources for purchasing devices, and attitudes toward the purchasing process. The role of "clinical engineering" is seen by these stakeholders to be critical in mediating between training, technical, and financial stakeholders but not always recognized in practice. CONCLUSIONS: The findings show that many device purchasing decisions are tackled in isolation, which is not optimal for decisions requiring knowledge that is currently distributed among different people within different departments. The challenges expressed relate to the wider system of care and equipment management, calling for a more systemic view of purchasing for medical devices.

Challenges in visible wavelength detection using optically transparent oxide semiconductors

We discuss the development of amorphous oxide semiconductor technology for optical sensor applications. In particular, we discuss the challenges of detecting visible wavelengths using this family of materials, which are known to be optically transparent due to their relatively large bandgap energy. One of the main issues with amorphous oxide semiconductors (AOS) is the ionization of the oxygen vacancies (VO) under illumination. While this can be beneficial in terms of optical absorption and high photoconductive gain, it can give rise to persistent photoconductivity (PPC). We will present techniques to overcome the PPC, and discuss how to achieve the high photoconductive gain for image sensor applications. © 2012 IEEE.

Fertile-free fuels in pressurized water reactors: Design challenges and solutions

This paper investigates the basic feasibility of using reactor-grade Pu in fertile-free fuel (FFF) matrix in pressurized water reactors (PWRs). Several important issues were investigated in this work: the Pu loading required to achieve a specific interrefueling interval, the impact of inert matrix composition on reactivity constrained length of cycle, and the potential of utilizing burnable poisons (BPs) to alleviate degradation of the reactivity control mechanism and temperature coefficients. Although the subject was addressed in the past, no systematic approach for assessment of BP utilization in FFF cores was published. In this work, we examine all commercially available BP materials in all geometrical arrangements currently used by the nuclear industry with regards to their potential to alleviate the problems associated with the use of FFF in PWRs. The recently proposed MgO-ZrO2 solid-state solution fuel matrix, which appears to be very promising in terms of thermal properties and radiation damage resistance, was used as a reference matrix material in this work. The neutronic impact of the relative amounts of MgO and ZrO2 in the matrix were also studied. The analysis was performed with a neutron transport and fuel assembly burnup code BOXER. A modified linear reactivity model was applied to the two-dimensional single fuel assembly results to approximate the full core characteristics. Based on the results of the performed analyses, the Pu-loaded FFF core demonstrated potential feasibility to be used in existing PWRs. Major FFF core design problems may be significantly mitigated through the correct choice of BP design. It was found that a combination of BP materials and geometries may be required to meet all FFF design goals. The use of enriched (in most effective isotope) BPs, such as 167Er and 157Gd, may further improve the BP effectiveness and reduce the fuel cycle length penalty associated with their use.

Future, opportunities and challenges of inkjet technologies

Inkjet printing relies on the formation of small liquid droplets to deliver precise amounts of material to a substrate under digital control. Inkjet technology is becoming relatively mature and is of great industrial interest thanks to its flexibility for graphical printing and its potential use in less conventional applications such as additive manufacturing and the production of printed electronics and other functional devices. Its advantages over traditional methods of printing include the following: it produces little or no waste, it is versatile because several different methods exist, it is noncontact, and it does not require a master template so that printed patterns can be readily modified on demand. However, the technology is in need of further development to become mainstream in emerging applications such as additive manufacturing (3D printing). This review contains a description of conventional and less common inkjet methods and surveys the current applications of inkjet in industry. This is followed by specific examples of the barriers, limitations, and challenges faced by inkjet technology in both graphical printing and manufacturing. © 2013 by Begell House, Inc.

Achievements and challenges in machine vision-based inspection of large concrete structures

Large concrete structures need to be inspected in order to assess their current physical and functional state, to predict future conditions, to support investment planning and decision making, and to allocate limited maintenance and rehabilitation resources. Current procedures in condition and safety assessment of large concrete structures are performed manually leading to subjective and unreliable results, costly and time-consuming data collection, and safety issues. To address these limitations, automated machine vision-based inspection procedures have increasingly been proposed by the research community. This paper presents current achievements and open challenges in vision-based inspection of large concrete structures. First, the general concept of Building Information Modeling is introduced. Then, vision-based 3D reconstruction and as-built spatial modeling of concrete civil infrastructure are presented. Following that, the focus is set on structural member recognition as well as on concrete damage detection and assessment exemplified for concrete columns. Although some challenges are still under investigation, it can be concluded that vision-based inspection methods have significantly improved over the last 10 years, and now, as-built spatial modeling as well as damage detection and assessment of large concrete structures have the potential to be fully automated.

System Dynamics and Scenario Planning: Implementation Challenges

In this paper we discuss key implementation challenges of a systems approach that combines System Dynamics, Scenario Planning and Qualitative Data Analysis methods in tackling a complex problem. We present the methods and the underlying framework. We then detail the main difficulties encountered in designing and planning the Scenario Planning workshop and how they were overcome, such as finding and involving the stakeholders and customising the process to fit within timing constraints. After presenting the results from this application, we argue that the consultants or system analysts need to engage with the stakeholders as process facilitators and not as system experts in order to gain commitment, trust and to improve information sharing. They also need be ready to adapt their tools and processes as well as their own thinking for more effective complex problem solving.

Development of low-pH cements for immobilisation of intermediate level radioactive waste: Achievements and challenges

Although cementation is a widely recognized solidification/ stabilization process for immobilisation of Intermediate Level Radioactive Waste (ILRW), the low resistance to hyperalkaline pore waters compromises the effectiveness of the process when Portland Cement (PC) is employed. Moreover the manufacture of PC is responsible for significant CO2 emissions. In this context, low pH cements are environmentally more suitable and have emerged as a potential alternative for obtaining secure waste forms. This paper summarises the achievements on development of low-pH cements and the challenges of using these new materials for the ILRW immobilisation. The performance of waste forms is also discussed in terms of radionuclides release. Reactive magnesium oxide and magnesium phosphate cements are emphasised as they feature important advantages such as consumption of available constituents for controlling acid-base reactions, reduced permeability and higher density. Additionally, in order to identify new opportunities for study, the long-term modelling approach is also briefly discussed. Copyright © 2013 by ASME.