Noise levels in a general intensive care unit : a descriptive study.

The aim of this small-scale study was to measure, analyse and compare levels of acoustic noise, in a nine-bedded general intensive care unit (ICU). Measurements were undertaken using the Norsonic 116 sound level meter recording noise levels in the internationally agreed ‘A’ weighted scale. Noise level data were obtained and recorded at 5 min over 3 consecutive days. Results of noise level analysis indicated that mean noise levels within this clinical area was 56·42 dB(A), with acute spikes reaching 80 dB(A). The quietest noise level attained was that of 50 dB(A) during sporadic intervals throughout the 24-h period. Parametric testing using analysis of variance found a positive relationship (p ≤ 0·001) between the nursing shifts and the day of the week. However, Scheffe multiple range testing showed significant differences between the morning shift, and the afternoon and night shifts combined (p ≤ 0·05). There was no statistical difference between the afternoon and night shifts (p ≥ 0·05). While the results of this study may seem self-evident in many respects, what it has highlighted is that the problem of excessive noise exposure within the ICU continues to go unabated. More concerning is that the prolonged effects of excessive noise exposure on patients and staff alike can have deleterious effect on the health and well-being of these individuals.

Noise levels in a General Surgical Ward : a descriptive study

Aims and objectives.  This study was undertaken to measure and analyse levels of acoustic noise in a General Surgical Ward. Method.  Measurements were undertaken using the Norsonic 116 sound level meter (SLM) recording noise levels in the internationally agreed ‘A’ weighted scale. Noise level data and observational data as to the number of staff present were obtained and recorded at 5-min intervals over three consecutive days. Results.  Results of noise level analysis indicated that mean noise level within this clinical area was 42.28 dB with acute spikes reaching 70 dB(A). The lowest noise level attained was that of 36 dB(A) during the period midnight to 7 a.m. Non-parametric testing, using Spearman's Rho (two-tailed), found a positive relationship between the number of staff present and the level of noise recorded, indicating that the presence of hospital personnel strongly influences the level of noise within this area. Relevance to clinical practice.  Whilst the results of this may seem self-evident in many respects the problems of excessive noise production and the exposure to it for patients, hospital personnel and relatives alike continues unabated. What must be of concern is the psychophysiological effects excessive noise exposure has on individuals, for example, decreased wound healing, sleep deprivation and cardiovascular stimulation.

Mindfulness-meditation on the move : implementation of an ACT-based mindfulness practice intervention and training within a University Dance program

As part of the introduction of a broader dance medicine and science related health and wellbeing program, a 9 week mindfulness-meditation ACT-based program was delivered to all students undertaking full-time University dance training (N = 106). The aim of the program was to assist students in the further development of performance psychology skills that could be applied in both performance and non-performance settings. Participant groups were comprised of both male (N = 12) and female (N = 94) students from across all three year levels of two undergraduate dance courses, divided into three groups by mixed year levels due to timetable scheduling requirements. Pre- and post-testing was undertaken utilising the Mindful Attention Awareness Scale (MAAS-15), a uni-dimensional measure of mindfulness, in addition to qualitative questions checking the current level of awareness and understanding of mindfulness practice and its application. Weekly sessions were conducted by qualified sport and exercise psychologists and covered key practices such as: Mindfulness of Body, Mindfulness of Breathing, Mindfulness of Sounds, ACT-based and general Imagery exercises, Developing Open Awareness, Mindfulness of Emotions, and Developing Inner Stillness. Students were required to maintain a reflective journal that was utilised at the end of each weekly session, in addition to completion of a mid-Semester reflective debrief. Teaching staff additionally attended the weekly sessions and linked the mindfulness practice learnings into the student’s practical dance and academic classes where appropriate. Anecdotal feedback indicates that participation in the mindfulness-meditation sessions and the development of these mental skills has resulted in positive performance and personal outcomes. Observations collated from staff and students, results from the data collection phases and recommendations regarding future applications within dance training settings will be discussed within the presentation.

ICANN and the concept of democratic deficit

The Internet Corporation for Assigned Names and Numbers (ICANN) is an institution besieged. It has endeavored to be democratic but its attempts to do so have been disastrous. The typical explanation for this is that the problem is with ICANN: it fails to meet its democratic obligations. My view is that the problem is with our understanding of "democracy." Democracy is an empty concept that fails to describe few, if any, of our genuine political commitments. In the real world, the failings inherent in "democracy" have been papered over by some unusual characteristics of the physical political process. However, in online trans-national institutions like ICANN, democracy is exposed as a poor substitute for a number of other conceptions of our political commitments. This Article seeks to articulate these political commitments and to explain why democracy and ICANN are such a poor mix. It begins by charting the rise of ICANN and its attempts to be democratic. It then explains why democracy is an empty shell of a concept. It then explores some features of democracy and ICANN, explaining why the online world exposes limitations in implications of democracy such as the nature of the demos, the idea of constituencies, direct democracy, voting, and the like. It concludes that ICANN's example demonstrates that democracy is in fact anything but a coherent general theory of political action. We need to consider, then, whether we should continue to berate ICANN for its undemocratic actions.

Robust speed tracking control of synchronous motors using immersion and invariance

This paper presents a novel control strategy for velocity tracking of Permanent Magnet Synchronous Machines (PMSM). The model of the machine is considered within the port-Hamiltonian framework and a control is designed using concepts of immersion and invariance (I&I) recently developed in the literature. The proposed controller ensures internal stability and output regulation, and it forces integral action on non-passive outputs.

Measurement of general and specific approaches to physical activity parenting : a systematic review

Background Parents play a significant role in shaping youth physical activity (PA). However, interventions targeting PA parenting have been ineffective. Methodological inconsistencies related to the measurement of parental influences may be a contributing factor. The purpose of this article is to review the extant peer-reviewed literature related to the measurement of general and specific parental influences on youth PA. Methods A systematic review of studies measuring constructs of PA parenting was conducted. Computerized searches were completed using PubMed, MEDLINE, Academic Search Premier, SPORTDiscus, and PsycINFO. Reference lists of the identified articles were manually reviewed as well as the authors' personal collections. Articles were selected on the basis of strict inclusion criteria and details regarding the measurement protocols were extracted. A total of 117 articles met the inclusionary criteria. Methodological articles that evaluated the validity and reliability of PA parenting measures (n=10) were reviewed separately from parental influence articles (n=107). Results A significant percentage of studies used measures with indeterminate validity and reliability. A significant percentage of articles did not provide sample items, describe the response format, or report the possible range of scores. No studies were located that evaluated sensitivity to change. Conclusion The reporting of measurement properties and the use of valid and reliable measurement scales need to be improved considerably.

General self-efficacy influences affective task reactions during a work simulation : the temporal effects of changes in workload at different levels of control

This study investigated the effects of workload, control, and general self-efficacy on affective task reactions (i.e., demands-ability fit, active coping, and anxiety) during a work simulation. The main goals were: (1) to determine the extent general self-efficacy moderates the effects of demand and control on affective task reactions, and; (2) to determine if this varies as a function of changes in workload. Participants (N=141) completed an inbox activity under conditions of low or high control and within low and high workload conditions. The order of trials varied so that workload increased or decreased. Results revealed individuals with high general self-efficacy reported better demands-abilities fit and active coping as well as less anxiety. Three interactive effects were found. First, it was found that high control increased demands-abilities fit from trial 1 to trial 2, but only when workload decreased. Second, it was found that low efficacious individuals active coping increased in trial 2, but only under high control. Third, it was found that high control helped high efficacious individuals manage anxiety when workload decreased. However, for individuals with low general self-efficacy, neither high nor low control alleviated anxiety (i.e., whether workload increased or decreased over time).

Promoting physical activity to older adults : a preliminary evaluation of three general practice-based strategies

The aim of this study was to explore the feasibility of an exercise scientist (ES) working in general practice to promote physical activity (PA) to 55 to 70 year old adults. Participants were randomised into one of three groups: either brief verbal and written advice from a general practitioner (GP) (G1, N=9); or individualised counselling and follow-up telephone calls from an ES, either with (G3, N=8) or without a pedometer (G2, N=11). PA levels were assessed at week 1, after the 12-wk intervention and again at 24 weeks. After the 12-wk intervention, the average increase in PA was 116 (SD=237) min/wk; N=28, p < 0.001. Although there were no statistically significant between-group differences, the average increases in PA among G2 and G3 participants were 195 (SD=207) and 138 (SD=315) min/wk respectively, compared with no change (0.36, SD=157) in G1. After 24 weeks, average PA levels remained 56 (SD=129) min/wk higher than in week 1. The small numbers of participants in this feasibility study limit the power to detect significant differences between groups, but it would appear that individualised counselling and follow-up contact from an ES, with or without a pedometer, can result in substantial changes in PA levels. A larger study is now planned to confirm these findings.

Depression and belongingness in general and workplace contexts : a cross-lagged longitudinal investigation

Belongingness has been linked to depression. Prior studies have been cross-sectional with few addressing distinct belongingness contexts. This study used structural equation modelling to investigate cross-lagged longitudinal relationships between general belonging, workplace belonging and depressive symptoms in a community sample of 221 working adults measured at two time points three months apart. Measures were: Sense of Belonging Instrument-Psychological (SOBI-P); Psychological Sense of Organizational Membership (PSOM); Depression Anxiety Stress Scales (DASS-21); Kessler Psychological Distress Scale (K10). General belonging was predicted more strongly by depressive symptoms than by baseline general belonging, suggesting that depressive symptoms not only linger but also influence future belongingness cognitions. Neither general nor workplace belonging longitudinally predicted depressive symptoms, however cross-sectional correlations were substantial. The concurrent path between general belongingness and depressive symptoms was strong. Results are consistent with daily process studies suggesting that reduced belongingness precipitates a rapid increase in depressive symptoms which influence longer term belongingness cognitions. Congruent with interpersonal descriptions of depression such as the social-cognitive interpersonal process model, results further suggest that belongingness cognitions are the proximal antecedent of a depressive response. Practitioners should monitor both a general sense of belonging as well as perceived relational value cues in specific contexts.

Promoting physical activity to older adults in general practice

This study aimed to assess the efficacy of a general practice based intervention to increase physical activity (PA) levels among 50-70 year old adults. One hundred and thirty-six inactive patients (50-70 years) were randomised into three groups. All participants received brief advice and a written prescription from a GP. Group one received this 'usual care' only (GP, n=46); group two received individualised counselling and follow-up contact from an Exercise Scientist (ES, n=45); group three received a pedometer to supplement the ES counselling (PED, n=45). The Active Australia Survey was administered at baseline, after the 12- week intervention and at a 24-week follow-up. One-way ANOVA showed no significant group differences at baseline in self-reported PA. Average time spent walking increased in all three groups at the 24-week follow-up (GP, 68158min/wk, p=0.006; ES, 83160min/wk, p=0.001; PED, 87132min/wk, p<0.001). Total time in PA (weighted min/wk) also increased significantly in all three groups (GP, 98 213min/wk, p=0.003; ES, 108 182min/wk, p<0.001; PED, 158 229min/wk, p<0.001 ). The proportion of participants who initially did not meet National PA Guidelines (150 minutes and 5 sessions/week) but who met the Guidelines at the 12 and 24-week follow-up was 15% (12 weeks) and 20% (24 weeks) in the GP group compared with 36% and 24% in the ES group and 20% and 42% in the PED group. All three intervention strategies were effective in increasing PA, but the ES intervention resulted in a higher proportion of active participants after 12 weeks and the PED group resulted in a higher proportion of active participants after 24 weeks.

Promoting physical activity to older adults through general practice

This study aimed to assess the efficacy of a general practice based intervention to increase physical activity (PA) levels among 50-70 year old adults. One hundred and thirty-six inactive patients (50-70 years) were randomised into three groups. All participants received brief advice and a written prescription from a GP. Group one received this 'usual care' only (GP, n=46); group two received individualised counselling and follow-up contact from an Exercise Scientist (ES, n=45); group three received a pedometer to supplement the ES counselling (PED, n=45). The Active Australia Survey was administered at baseline, after the 12- week intervention and at a 24-week follow-up. One-way ANOVA showed no significant group differences at baseline in self-reported PA. Average time spent walking increased in all three groups at the 24-week follow-up (GP, 68158min/wk, p=0.006; ES, 83160min/wk, p=0.001; PED, 87132min/wk, p<0.001). Total time in PA (weighted min/wk) also increased significantly in all three groups (GP, 98 213min/wk, p=0.003; ES, 108 182min/wk, p<0.001; PED, 158 229min/wk, p<0.001 ). The proportion of participants who initially did not meet National PA Guidelines (150 minutes and 5 sessions/week) but who met the Guidelines at the 12 and 24-week follow-up was 15% (12 weeks) and 20% (24 weeks) in the GP group compared with 36% and 24% in the ES group and 20% and 42% in the PED group. All three intervention strategies were effective in increasing PA, but the ES intervention resulted in a higher proportion of active participants after 12 weeks and the PED group resulted in a higher proportion of active participants after 24 weeks.

Building community coalitions for the promotion of physical activity: 10,000 steps Rockhampton

The 10,000 Steps Rockhampton project is a multi-strategy community-wide, physical activity intervention based on the simultaneous implementation of five strategies, each identified as 'best practice' for the promotion of physical activity. Several community partners were engaged to develop and implement the strategies during the first eighteen months of the project. These included: the local media (TV, newspaper and radio); the local Division of General Practice and other health professional groups; the Heart Foundation and ‘Just Walk It’; the local council; and several large worksites. A local physical activity task force was also formed to administer a 'micro-grants' scheme, and to guide the development of community based strategies. The presentation will focus on the critical elements involved in developing and maintaining relationships with community partners. These include identification and ‘courting’ of potential partners, strategies for keeping them engaged, and the challenges of maintaining the balance between ‘top-down’ (evidence-based) and ‘bottom-up’ (community-driven) strategies. Data on implementation and uptake of the key strategies will also be presented. These include: 1) process data on the number of health

Executive function and postural instability in people with Parkinson’s disease

The specific aspects of cognition contributing to balance and gait have not been clarified in people with Parkinson’s disease (PD). Twenty PD participants and twenty age- and gender-matched healthy controls were assessed on cognition and clinical mobility tests. General cognition was assessed with the Mini Mental State Exam and the Addenbrooke’s Cognitive Exam. Executive function was evaluated using the Trail Making Tests (TMT-A and TMT-B) and a computerized cognitive battery which included a series of choice reaction time (CRT) tests. Clinical gait and balance measures included the Tinetti, Timed Up & Go, Berg Balance and Functional Reach tests. PD participants performed significantly worse than the controls on the tests of cognitive and executive function, balance and gait. PD participants took longer on Trail Making Tests, CRT-Location and CRT-Colour (inhibition response). Furthermore, executive function, particularly longer times on CRT-Distracter and greater errors on the TMT-B were associated with worse balance and gait performance in the PD group. Measures of general cognition were not associated with balance and gait measures in either group. For PD participants, attention and executive function were impaired. Components of executive function, particularly those involving inhibition response and distracters, were associated with poorer balance and gait performance in PD.