E. Beinat

Electromagnetic Interference From Radio Frequency Identification Inducing Potentially Hazardous Incidents in Critical Care Medical Equipment

CONTEXT Health care applications of autoidentification technologies, such as radio frequency identification (RFID), have been proposed to improve patient safety and also the tracking and tracing of medical equipment. However, electromagnetic interference (EMI) by RFID on medical devices has never been reported. OBJECTIVE To assess and classify incidents of EMI by RFID on critical care equipment. DESIGN AND SETTING Without a patient being connected, EMI by 2 RFID systems (active 125 kHz and passive 868 MHz) was assessed under controlled conditions during May 2006, in the proximity of 41 medical devices (in 17 categories, 22 different manufacturers) at the Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. Assessment took place according to an international test protocol. Incidents of EMI were classified according to a critical care adverse events scale as hazardous, significant, or light. RESULTS In 123 EMI tests (3 per medical device), RFID induced 34 EMI incidents: 22 were classified as hazardous, 2 as significant, and 10 as light. The passive 868-MHz RFID signal induced a higher number of incidents (26 incidents in 41 EMI tests; 63%) compared with the active 125-kHz RFID signal (8 incidents in 41 EMI tests; 20%); difference 44% (95% confidence interval, 27%-53%; P < .001). The passive 868-MHz RFID signal induced EMI in 26 medical devices, including 8 that were also affected by the active 125-kHz RFID signal (26 in 41 devices; 63%). The median distance between the RFID reader and the medical device in all EMI incidents was 30 cm (range, 0.1-600 cm). CONCLUSIONS In a controlled nonclinical setting, RFID induced potentially hazardous incidents in medical devices. Implementation of RFID in the critical care environment should require on-site EMI tests and updates of international standards.

Value functions for environmental management

Environmental decisions are not like all other decisions, at least not always. The information for environmental decisions is often poor or insufficient. This is the case not only for decisions with limited consequences, but also for decisions with considerable consequences. There is a serious gap between the information needed and the information available for environmental decisions.

Multicriteria Analysis for Land-Use Management

Preface. I. Problem Structuring for Land-Use Management. II. The Multiple Dimensions of Land-Use Management. III. Multiple Actors and Multiple Perspectives in Land-Use Decisions. IV. Spatial Information in Land-Use Management. V. Looking Ahead. List of Authors.

Location Interoperability Services for Medical Emergency Operations during Disasters

The organizational structure that deals with the Response phase in disaster and risk management is based on a strong co-operation between several organizations, such as the police, fire departments, the local government and the health services The size of the organization depends largely upon the scale of the disaster itself. Van Dijke 2003 identifies 31 processes, that concern information flows and coordination of forces, that are relevant in these cases.

Value functions for environmental pollutants: A technique for enhancing the assessment of expert judgements.

This paper presents a new procedure to assess value functions for environmental pollutants. It has been particularly designed for eliciting expert-based value functions for pollutant substances. The main features of the model are the possibility to integrate direct and indirect assessment techniques, the possibility to make explicit assessment uncertainties and to avoid forcing quantitative judgements. The main aim of the procedure is to improve the reliability of the assessment but also to make the experts task easier by using qualitative judgements more frequently. The procedure has been developed especially for soil pollutants, for which an application is described.

Spatial Conflicts in Transport Policies: an Exploration of the Perspectives of Local and Regional Actors

Transport policies in the European Union are directed towards the integration of national and local policies while maintaining national and regional identities. Since few policies are able to satisfy all needs and demands of all areas involved, spatial conflicts often occur. This paper discusses the nature and characteristics of these conflicts and introduces a framework for their study. The discussion is based on a large infrastructure project in the Netherlands. The paper addresses spatial conflicts on the basis of the results of the public participation process, and on the basis of a value function model assessed for individual spatial units. The objections raised to the project by regional authorities, local administrations and citizens are explored to analyse the spatial distribution of objections and the reason for the intensity and distribution observed. The value function models are used to analyse the attractiveness of the proposed plan from the perspective of each unit. Differences between units and the reasons for conflicts are then identified. Conflict resolution measures are briefly discussed within the framework of the project.

Multi-objective decision-making for soil remediation problems

After deciding whether or not a soil clean-up operation is necessary, the question remains which remedial strategy and technique should be applied. Traditionally, remediation techniques aim at reaching environmental threshold values within the shortest possible time. There is, however, a growing awareness that other aspects should be included when assessing remedial actions. Striving for optimal soil quality at a polluted site may result in the transfer of contamination to other media and a considerable use of economic and natural resources. The triple-perspective REC framework simultaneously takes into account Risk reduction, Environmental performance and Cost, and aims to increase the effectiveness and efficiency of clean-up operations. Within the REC framework, the risk reduction perspective aims at minimizing the effects of contamination and remediation on potential receptors at the site. The environmental merit perspective, which stems from a life-cycle inventory approach, aims at minimizing the use of scarce commodities and the contamination of other compartments due to remedial activities. Finally, the costs perspective aims at minimizing the total costs in terms of net present value. This paper describes the method and illustrates an application.

A Multiple Criteria Approach to the Estimation of Environmental Quality

This paper shows the role of multicriteria value functions in the context of environmental decision making. It focuses on the structuring of expert judgement and on the information necessary to overcome the problems related to the customary evaluation based on environmental standards. These standards, although widely used, do not provide sufficient support for the decision process and do not allow for compromises between multiple objectives. The shortcomings of the standards are highlighted, the necessary information to improve decision making is discussed and the use of value function techniques is illustrated.

Soils: A System to Support Decisions on Cleaning-up Polluted Sites

The SOILS system supports the selection of the best clean-up strategy for a polluted site. The system predicts and evaluates the results and effects of these strategies. In this paper we will focus on the evaluation module of the SOILS system. This module makes use of value functions, multicriteria methods and sensitivity analysis to translate the predicted results into a rank order of the alternatives and/or into recommendations for additional research. Value functions establish a relationship between a physical score, such as the remaining concentration of a pollutant in the soil, and the importance of that score. A procedure has been developed to estimate these value functions using expert judgement in various forms.

Expert-Based Value Functions for Soil Pollutants: Assessment and Aggregation of Responses

The paper shows the application of additive value functions for the evaluation of soil pollutants. Expert-based value functions are used to represent expert knowledge and preferences on single pollutants and on combinations of contaminants. The resulting value function model is used to rank remediation alternatives for polluted sites. The paper addresses the assessment of value functions and weights and the aggregation of different expert responses. Major attention is given to the empirical and practical consequences of different aggregation rules and strategies. The results obtained show that in the applications considered, the simple average rule provides satisfactory results, in line with other rules, and that the different aggregation strategies give consistent outcomes.