Creating a therapeutic environment : a non-randomised controlled trial of a quiet time intervention for patients in acute care

Background: Noise is a significant barrier to sleep for acute care hospital patients, and sleep has been shown to be therapeutic for health, healing and recovery. Scheduled quiet time interventions to promote inpatient rest and sleep have been successfully trialled in critical care but not in acute care settings. Objectives: The study aim was to evaluate as cheduled quiet time intervention in an acute care setting. The study measured the effect of a scheduled quiet time on noise levels, inpatients’ rest and sleep behaviour, and wellbeing. The study also examined the impact of the intervention on patients’, visitors’ and health professionals’ satisfaction, and organisational functioning. Design: The study was a multi-centred non-randomised parallel group trial. Settings: The research was conducted in the acute orthopaedic wards of two major urban public hospitals in Brisbane, Australia. Participants: All patientsadmitted to the two wards in the5-month period of the study were invited to participate, withafinalsample of 299 participants recruited. This sample produced an effect size of 0.89 for an increase in the number of patients asleep during the quiet time. Methods: Demographic data were collected to enable comparison between groups. Data for noise level, sleep status, sleepiness and well being were collected using previously validated instruments: a Castle Model 824 digital sound level indicator; a three point sleep status scale; the Epworth Sleepiness Scale; and the SF12 V2 questionnaire. The staff, patient and visitor surveys on the experimental ward were adapted from published instruments. Results: Significant differences were found between the two groups in mean decibel level and numbers of patients awake and asleep. The difference in mean measured noise levels between the two environments corresponded to a ‘perceived’ difference of 2 to 1. There were significant correlations between average decibel level and number of patients awake and asleep in the experimental group, and between average decibel level and number of patients awake in the control group. Overall, patients, visitors and health professionals were satisfied with the quiet time intervention. Conclusions: The findings show that a quiet time intervention on an acute care hospital ward can affect noise level and patient sleep/wake patterns during the intervention period. The overall strongly positive response from surveys suggests that scheduled quiet time would be a positively perceived intervention with therapeutic benefit.

The Second Life of urban planning? Using neogeography tools for community engagement

The majority of the world’s citizens now live in cities. Although urban planning can thus be thought of as a field with significant ramifications on the human condition, many practitioners feel that it has reached the crossroads in thought leadership between traditional practice and a new, more participatory and open approach. Conventional ways to engage people in participatory planning exercises are limited in reach and scope. At the same time, socio-cultural trends and technology innovation offer opportunities to re-think the status quo in urban planning. Neogeography introduces tools and services that allow non-geographers to use advanced geographical information systems. Similarly, is there potential for the emergence of a neo-planning paradigm in which urban planning is carried out through active civic engagement aided by Web 2.0 and new media technologies thus redefining the role of practicing planners? This paper traces a number of evolving links between urban planning, neogeography and information and communication technology. Two significant trends – participation and visualisation – with direct implications for urban planning are discussed. Combining advanced participation and visualisation features, the popular virtual reality environment Second Life is then introduced as a test bed to explore a planning workshop and an integrated software event framework to assist narrative generation. We discuss an approach to harness and analyse narratives using virtual reality logging to make transparent how users understand and interpret proposed urban designs.

Developing a participatory impact assessment approach and action research culture within a communication for social change organisation in Nepal

Developing an effective impact evaluation framework, managing and conducting rigorous impact evaluations, and developing a strong research and evaluation culture within development communication organisations presents many challenges. This is especially so when both the community and organisational context is continually changing and the outcomes of programs are complex and difficult to clearly identify.----- This paper presents a case study from a research project being conducted from 2007-2010 that aims to address these challenges and issues, entitled Assessing Communication for Social Change: A New Agenda in Impact Assessment. Building on previous development communication projects which used ethnographic action research, this project is developing, trailing and rigorously evaluating a participatory impact assessment methodology for assessing the social change impacts of community radio programs in Nepal. This project is a collaboration between Equal Access – Nepal (EAN), Equal Access – International, local stakeholders and listeners, a network of trained community researchers, and a research team from two Australian universities. A key element of the project is the establishment of an organisational culture within EAN that values and supports the impact assessment process being developed, which is based on continuous action learning and improvement. The paper describes the situation related to monitoring and evaluation (M&E) and impact assessment before the project began, in which EAN was often reliant on time-bound studies and ‘success stories’ derived from listener letters and feedback. We then outline the various strategies used in an effort to develop stronger and more effective impact assessment and M&E systems, and the gradual changes that have occurred to date. These changes include a greater understanding of the value of adopting a participatory, holistic, evidence-based approach to impact assessment. We also critically review the many challenges experienced in this process, including:----- • Tension between the pressure from donors to ‘prove’ impacts and the adoption of a bottom-up, participatory approach based on ‘improving’ programs in ways that meet community needs and aspirations.----- • Resistance from the content teams to changing their existing M&E practices and to the perceived complexity of the approach.----- • Lack of meaningful connection between the M&E and content teams.----- • Human resource problems and lack of capacity in analysing qualitative data and reporting results.----- • The contextual challenges, including extreme poverty, wide cultural and linguistic diversity, poor transport and communications infrastructure, and political instability.----- • A general lack of acceptance of the importance of evaluation within Nepal due to accepting everything as fate or ‘natural’ rather than requiring investigation into a problem.

Gendered perceptions of experiential value in using web-based retail channels

Purpose – This paper compares the experiential consumption values that motivate consumer choice to purchase online for both male and female purchasers and non-purchasers. Design/methodology/approach – Using the theory of consumption value the study examines gendered perceptions of the functional, social and conditional value of using a virtual consumption setting for purchasing. Data was collected through an online survey and analysed using multiple discriminant analysis to determine meaningful differences between male and female purchasers and non-purchasers. Findings – The findings show that male online purchasers are discriminated from female purchasers by social value and from male non-purchasers by conditional value. Female purchasers are discriminated from male purchasers by functional value and from female non-purchasers by social value. Female non-purchasers are discriminated from female purchasers by conditional value. Male non-purchasers are discriminated from male purchasers by functional and social value. Research limitations/implications – Limitations include using an Internet survey and an Australian sample which may impact the generalisability of the findings to a wider population of Internet users. Future research should involve replication of the study in a country more or less developed in terms of gender composition of internet users to extend the generalisability of the findings. Additionally, researchers should examine whether other dimensions of consumption value,such as social influence through on- and off-line communication networks, may influence consumer choice to purchase online. Practical implications – The study provides practical implications for marketers to leverage consumption values that influence male and female consumers’ choice to purchase online and then drive their behaviour online through integrated marketing campaigns that involve both on- and offline strategies. Originality/value – The research makes an original contribution to the consumer behaviour literature as to date, no research has been found that undertakes such a comprehensive gender-based comparison of the perceived value of using a virtual consumption setting for purchasing.

Socialising across channels : group multichannel communication

People increasingly communicate over multiple channels, such as SMS, email and IM. Choosing the channel for interaction is typically a considered action and shapes the message itself. In order to explore how people make sense of communication mediums and more generally, social group behaviour, we developed a multichannel communication prototype. Preliminary results indicate that multichannel communication was considered very useful in the group context even considering the increased quantity of messages while it was little used for person-to-person interaction.

Bridging technical and HCI research : creating usable ubiquitous computing

This paper describes methods used to support collaboration and communication between practitioners, designers and engineers when designing ubiquitous computing systems. We tested methods such as “Wizard of Oz” and design games in a real domain, the dental surgery, in an attempt to create a system that is: affordable; minimally disruptive of the natural flow of work; and improves human-computer interaction. In doing so we found that such activities allowed the practitioners to be on a ‘level playing ground’ with designers and engineers. The findings we present suggest that dentists are willing to engage in detailed exploration and constructive critique of technical design possibilities if the design ideas and prototypes are presented in the context of their work practice and are of a resolution and relevance that allow them to jointly explore and question with the design time. This paper is an extension of a short paper submitted to the Participatory Design Conference, 2004.

Leveraging mundane technologies for group mobile social communication

This paper outlines results from the long-term deployment of a system for mobile group socialization which utilizes a variety of mundane technologies to support cross-media notifications and messaging. We focus here on the results as they pertain to usage of mundane technologies, particularly the use of such technologies within the context of a cross-media system. We introduce “Rhub”, our prototype, which was designed to support coordination, communication and sharing amongst informal social groups. We also describe and discuss the usage of the “console,” a text-based syntax to enable consistent use across text messaging, instant messaging, email and the web. The prototype has been in active use for over 18 months by over 170 participants, who have used it on an everyday basis for their own socializing requirements.

Co-creating games: A co-evolutionary analysis

ABSTRACT. The phenomenon of consumer co-creation is often framed in terms of whether either economic market forces or socio-cultural non-market forces ultimately dominate. We propose an alternate model of consumer co-creation in terms of co-evolution between markets and non-markets. Our model is based on a recent ethnographic study of a massively multiplayer online game through its development, release and ultimate failure, and cast in terms of two explanatory models: multiple games and social network markets. We conclude that consumer co-creation is indeed complex, but in ways that relate to both emergent market expectations and the evolution of markets, not to the transcendence of markets.