Documenting the environmental performance of building products is becoming widespread because of green building programs and concerns that some green-marketing claims are misleading (i.e., green-washing). Developing environmental product declarations (EPDs) based on life-cycle assessment (LCA) data is one way to provide scientific documentation. Many U.S. structural wood products have LCA-based “eco-labels ” using the ISO standard. However, the standard requires underlying life-cycle inventory (LCI) data to be recent. This study updates the gate-to-gate manufacturing LCI data for laminated veneer lumber (LVL) for the Pacific northwestern (PNW) and southeastern (SE) United States. Modeling the primary industry data for LVL through LCI analysis provides the inputs and outputs from veneer logs to LVL, starting at the forest landing. For PNW and SE, cumulative mass-allocated energy consumption associated with manufacturing LVL was found to be 5.64 and 6.87 GJ/m3, respectively, with about 25 % of the primary energy derived from wood residues. Structural wood products such as LVL used in building construction can store carbon for long periods, which is typically greater or far greater than the carbon dioxide emissions released during manufacturing. Emission data produced through modeling found that estimated biomass and fossil CO2 emissions for LVL manufacturing were 127 and 139 kg/m3 for PNW and 108 and 169 kg/m3 for SE. One

Wood products and other building materials used in new residential construction in the United States, with comparison to previous studies, 2012

fidis-wp13-del13.8.pdf

“D13.1: Identity and impact of privacy enhancing technologie”

This article presents efforts at improving the use of clinical alarms. The article reviews literature related to clinical alarms and analyzes adverse event databases. The authors also evaluate efforts to improve alarm management through technological standards and regulations. Utilizing feedback from forums, meetings and a survey the authors capture crucial information across several disciplines inclusive of clinicians, engineers, technical staff and managers. Several themes that directly impact alarm management is highlighted. The article provides a general framework for manufacturers, clinicians and educators who are charged with ensuring patient safety through the use effective alarms.

Study objective: To determine the effect which modifying the behaviors to reduce the general environmental noise: examples would be loud talking pagers not on vibrate and televisions in common areas. Design: The study was divided into two separate phases: noise identification and a trial of behavior modification. Sound was measured with sound level meters and objective observes in a variety of locations at set times to allow for comparison between the phases of the sturdy. This was done in a before and after model. The changes were measured over a multi week period. The Study compared the baseline and post-behavior modification noise levels with a matched number of patients in the room, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores for equivalency. Results: The results of the study show that it is possible to have the total sound envelope be reduced by behavior modification- for example the sound pressure from television and talking alone accounted for 49 % of the measured audio energy. Also notable was that the measured sound in the hospital environment far exceeded the EPA recommended Hospital

The paper describes the issues and concerns with the audio component of many of the alarm systems in common use today. The article advocates the opinion that many of the problems with alarms could be considerably reduced through application of human factors to the problem. To support this thesis many papers are cited. The article details the philosophy of alarms and their associated sounds and how they are effectively used. The article describes the issues of alarm design and human cognition with respect to urgency and priority as well as the domain of activity – such as alarms for ventilators being differentiable from alarms for cardiac monitors. Specific details on the shortcomings of the IEC 60601-1-8 standard are also described.

This paper reports the results of a prospective, observational, clinical study that took place in a Medical ICU in one hospital in Germany. Physiologic data at 1-second intervals, monitor alarms, and alarm settings were acquired and saved. Patients were videotaped and the resulting video recordings were annotated for alarm relevance and technical validity by an experienced physician. During 982 hours of observation, 5,934 alarms were annotated (6 alarms per hour). The majority of alarms (70%) were threshold alarms (measured physiologic parameters were outside a predefined range). Most of these threshold alarms (45%) were caused by systolic blood pressure. About 40 % of all alarms were technically false, and 68 % of those were caused by manipulation. Only 15 % of all alarms were considered clinically relevant. The authors concluded that the vast majority of alarms are not associated with a clinically relevant situation. They offered strategies to reduce these alarms, e.g., educating staff to silence alarms when doing direct patient care, changing threshold limits.

This study measures the occurrence and duration of specific alarms (HR, SpO2, and Resp Rate only) in a NICU and their relationship to the response of the nurses in the unit. Although this was a 22 bed unit, the study focused on a 6 patient care area where the most acute infants are treated. This study found that the high number of alarms prevents a nurse from responding to all alarms. Instead, alarms functioned more as an indicator about the patient’s status that the nurse integrated with other information to adjust their sequencing of care activities. However, in the cases where an alarm lasted longer (for more than 5 seconds) or was a rarer occurring alarm (in this study that was the respiratory alarm in comparison to the SpO2) there was a tendency for the nurse to intervene more quickly. The authors also questioned whether nurses learn to respond to alarm pattern variations between patients rather than just to an alarm. The authors concluded alarm systems must reduce the number of alarms, while assisting in sequencing of activities, noting “If alarms serve as meaningful information sources, they

Discusses problems with the current design of alarms with respect to their not being perceived due to high incidence of “false alarms ” that have “no clinical relevance. ” The approaches currently used to improve this situation are: (1) Organizational, and Behavioral, and (2) Technical The review discusses the theory of alarms and monitoring and references studies throughout. European Standards are reviewed with respect to how they classify alarm priority for various alarm types. Alarm technologies focused on as examples in the review were mostly those found in critical care monitoring environments and involved reducing threshold values when monitoring SpO2 to reduce false alarms. “Multi-parametric” approaches for reducing false alarms are discussed briefly; several studies referenced but