Foreword

There is no doubt that the continued convergence of engineering, science and medicine in the 21^st century will drive new treatments, devices, drugs, diagnostics and therapies for healthcare. Worldwide there is a desperate need for effective and economical medical interventions to care for an ageing population that is growing in number and to help lessen the burden on healthcare systems of the frightening rise in chronic diseases and conditions such as diabetes and cardiovascular disease. The rise in chronic illness is to a great extent being driven by lifestyle changes and as countries become more prosperous and industrialised they see the burden of chronic illness rise. The numbers of people affected are notable. For example, the World Health Organisation (WHO) estimates that 346 million people worldwide have diabetes and that diabetes related deaths are set to double between 2005 and 2030. Type II Diabetes is growing because of sedentary lifestyles and obesity. It does not simply bring problems with blood sugar but complications of uncontrolled glucose levels can lead to cardiovascular disease, eyesight problems, renal problems and wound care problems, creating a complex and growing patient load for healthcare providers. Cardiovascular disease is even more prevalent and claimed the lives of 17.6 million in 2008 and the WHO estimates that this will rise to 26.3 million by 2030.

Thus governments and healthcare providers know that changes must be made to reduce chronic disease where possible, and to deliver care effectively and economically to those who are affected by it.

Medical technology and medical devices have a crucial part to play in helping society care for these populations and interventions based on technology and devices are already widespread and growing. The portable glucose meters which diabetics can use to check their blood sugar levels at any time were developed from biosensor technology and have now become a reliable fixture of diabetes treatment. Current research in the field has produced sub- dermal sensors for glucose that can be left in place for up to a week and the future will bring transdermal sensors that will use, or modify, the permeability of the skin to extract glucose for analysis. As another example, there is interest in the use of stem cells to grow new tissue or to repair damaged tissue and many of these types of intervention will require tissue scaffolds to guide and nourish the stem cells, thus materials scientists, engineers and life scientists are exchanging information in multidisciplinary research projects for tissue repair.

In terms of healthcare provision, governments, health services and medical companies are embracing the concept of delivering much of the monitoring and therapy for patients within their own homes rather than in hospitals and clinics. Where telehealth systems have been adopted for monitoring they have been well received by patients who can receive daily reassurance about their conditions by taking and relaying their own measurements to their clinicians. Developing medical situations that cause concern can trigger earlier interventions and treatment through telehealth monitoring and both hospital admissions and mortality are reduced where telehealth is properly implemented. This growing demand for home monitoring requires not only the advanced telecommunications and wireless systems that engineers have developed but more advances in sensor and imaging technology to allow a wide range of conditions to be monitored. This poses a big challenge requiring more bioelectronics based research and development.

It is clear that our current healthcare problems support the need for the training of more engineers and physicists in bioelectronics for medical device and technology development. It is crucial that good training is provided by experienced practitioners in bioelectronics. The fields of medicine, medical technologies and devices are heavily regulated environments and research projects must be based on cognisance of the human body and medical science as well as technology. It is too easy for well meaning teams of engineers and scientists to create research projects that cannot deliver to the clinical interface because key elements of biology, toxicology and the inflammatory response have not been understood. Teams who will make real advances in this sector will include clinicians and engineers and physicists who have knowledge of medical science and bioelectronics.

Beyond medical devices and healthcare needs, the field of bioelectronics has expanded to produce devices with micro and nano scale features that allow the study of individual cells in vitro or in vivo. Thus, for example, the response of an individual cardiac or neural cell to a pharmacological agent may be studied via a microfabricated biosensor in contact with the cell. The study of individual and group behaviour of cells provides important information for a range of researchers including biologists, materials scientists and pharmacologists. However, this is again a challenging area for researchers and device development and implementation in this field requires an understanding of engineering principles combined with cell biology. Knowledge of bioelectronics is thus a key need for a student entering this field.

Given the wide range of students that can be drawn from the sectors described above and their different needs Professor Pethig and Dr Smith are to be commended for producing an excellent textbook as an introduction to bioelectronics. It is clear from the content and style of the book that in these authors we have real researchers and teachers who perfectly understand the needs of the new student in the subject. All of the key basic elements of cell biology, biophysics and chemistry are clearly set out to ensure that the student understands the basics before the book moves on to introduce the key technologies in the field for sensors, instrumentation and spectroscopy. The book does not shy away from discussing practical problems in systems and the discussion and teaching on the problems of implanting biosensors will shed light on the disappointing results already obtained by many who are already working in this field.

I will be recommending this excellent textbook to my own students and I congratulate Professor Pethig and Dr Smith on their achievement.

Professor Patricia Connolly
FRSE FIET FRSM CEng

Director, Strathclyde Institute of Medical Devices
University of Strathclyde, Glasgow, Scotland