Barbara Oakley

Noise in hospital intensive care units—a critical review of a critical topic

PURPOSE The aims of the study were to examine the studies related to hospital noise in intensive care units (ICUs) to understand the sources and effects of noise and to describe best practices and common problems in the varying methods commonly applied to reduce the noise level. MATERIALS AND METHODS The ISI Web of Knowledge and PubMed were used to search original research articles to obtain articles related to hospital ICU noise analysis. RESULT This review article analyzes the 29 extant studies related to noise in ICUs. CONCLUSION Significant opportunities exist to improve methodologies to study noise levels to reduce noise in hospital ICUs. Many previous studies have used inconsistent methodologies with poorly defined parameters that make it difficult to compare results. Our work points out common pitfalls in the recording and sharing of hospital acoustic parameters and also points to the paucity of important economic considerations in extant studies. These results can be helpful for future research in this area. Many past salutary interventions--including educational noise reduction programs, behavioral modification using sound detection equipment, and low- as well as high-cost environmental alterations--do not generally appear to be adequate to minimize noise to levels for hospital rooms specified by international agencies. But a potentially important clue for future work involves the finding that as the number of patients and staff of the ICU increases, noise levels appear to also increase.

Best Practices Involving Teamwork in the Classroom: Results From a Survey of 6435 Engineering Student Respondents

A teamwork survey was conducted at Oakland University, Rochester, MI, in 533 engineering and computer science courses over a two-year period. Of the 6435 student respondents, 4349 (68%) reported working in teams. Relative to the students who only worked individually, the students who worked in teams were significantly more likely to agree that the course had achieved its stated learning objectives (p < 0.001). Regression analysis showed that roughly one-quarter of the variance in belief about whether the objectives were met could be explained by four factors: 1) student satisfaction with the team experience; 2) the presence of instructor guidance related to teamwork; 3) the presence of slackers on teams; and 4) team size. Pearson product-moment correlations revealed statistically significant associations between agreement that the course objectives had been fulfilled and the use of student teams and between satisfaction with teams and the occurrences of instructor guidance on teamwork skills. These and other results suggest that assigning work to student teams can lead to learning benefits and student satisfaction, provided that the instructor pays attention to how the teams and the assignments are set up.

Reducing Hospital Noise: A Review of Medical Device Alarm Management

Increasing noise in hospital environments, especially in intensive care units (ICUs) and operating rooms (ORs), has created a formidable challenge for both patients and hospital staff. A major contributing factor for the increasing noise levels in these environments is the number of false alarms generated by medical devices. This study focuses on discovering best practices for reducing the number of false clinical alarms in order to increase patient safety and provide a quiet environment for both work and healing. The researchers reviewed Pub Med, Web of Knowledge and Google Scholar sources to obtain original journal research and review articles published through January 2012. This review includes 27 critically important journal articles that address different aspects of medical device alarms management, including the audibility, identification, urgency mapping, and response time of nursing staff and different solutions to such problems. With current technology, the easiest and most direct method for reducing false alarms is to individualize alarm settings for each patients condition. Promoting an institutional culture change that emphasizes the importance of individualization of alarms is therefore an important goal. Future research should also focus on the development of smart alarms.

Using a system-on-a-chip implantable device to filter circulating infected cells in blood or lymph

This paper describes a system on a chip (SoC) that makes use of nanoscale cellular adhesion mechanisms in an integrated electronic microsystem to filter infected cells from blood or lymph. An example of a human immunodeficiency virus-specific SoC is explored in depth. Such systems work in vivo, and blood and lymph are filtered on a continuous basis. With the intelligence on the chip, captured cells can be identified and lyzed, expelled, or otherwise acted upon. These types of systems transfer the burden of research from traditional chemotherapy to bioengineering and system design.

Ultrasonic Parameters as a Function of Absolute Hydrostatic Pressure. I. A Review of the Data for Organic Liquids

This review provides an overview of experimental results involving ultrasonic parameters as a function of absolute hydrostatic pressure in organic liquids. Major topics of discussion include the pioneering work of Litovitz and Carnevale involving deduction of the chemical and structural properties of liquids from acoustical properties as a function of pressure; modern general ultrasonic studies of a broad range of organic liquids; work accomplished by Russians and others from the former Soviet block countries, particularly the work headed by Otpuschennikov at the Kursk Pedagogical Institute; the studies involving refrigerants published by Takagi at the Kyoto Institute of Technology; tribological and petroleum industry studies related to oils; Brillouin scattering experiments; and thermodynamic methods of B/A measurement. The importance of ultrasonic parameters as a function of pressure to the understanding of a variety of processes is highlighted. A table of 325 liquids and liquid mixtures with a total of...

Concepts and implications of altruism bias and pathological altruism

The profound benefits of altruism in modern society are self-evident. However, the potential hurtful aspects of altruism have gone largely unrecognized in scientific inquiry. This is despite the fact that virtually all forms of altruism are associated with tradeoffs—some of enormous importance and sensitivity—and notwithstanding that examples of pathologies of altruism abound. Presented here are the mechanistic bases and potential ramifications of pathological altruism, that is, altruism in which attempts to promote the welfare of others instead result in unanticipated harm. A basic conceptual approach toward the quantification of altruism bias is presented. Guardian systems and their over arching importance in the evolution of cooperation are also discussed. Concepts of pathological altruism, altruism bias, and guardian systems may help open many new, potentially useful lines of inquiry and provide a framework to begin moving toward a more mature, scientifically informed understanding of altruism and cooperative behavior.

Ultrasonic Parameters as a Function of Absolute Hydrostatic Pressure. II. Mathematical Models of the Speed of Sound in Organic Liquids

Polynomial expressions for the speed of sound as a function of pressure for 68 different organic liquids are presented in tabular form. (The liquids form a subset of those discussed in the companion paper: Ultrasonic parameters as a function of absolute hydrostatic pressure. I. A review of the data for organic liquids.) The polynomial expressions are based upon the experimental results reported by many different researchers. For some common liquids, such as benzene, hexane, ethanol, and carbon tetrachloride, the results of as many as five different researchers are reported. These results sometimes vary widely—far more than would be expected from calculated experimental uncertainties. An analysis is presented of how well pressure-dependent polynomials fit the experimental data when the number of coefficients is increased. The error in the polynomial fit is also explored when both pressure and temperature dependencies are present. Finally, differences between ultrasonic and Brillouin scattering experimental...

Reducing Hospital ICU Noise: A Behavior-Based Approach

Noise in Intensive Care Units (ICUs) is gaining increasing attention as a significant source of stress and fatigue for nursing staff. Extensive research indicates that hospital noise also has negative impact on patients. The objective of this study was to analyze noise variations as experienced by both nursing staff and patients, to gain a better understanding of noise levels and frequencies observed in ICU settings over extended (week-long) durations, and to implement a low cost behavior modification program to reduce noise. The results of our study indicate that behavioral modification alone is not adequate to control excessive noise. There is a need for further research involving the supportive involvement by clinicians, ICU staff, along with effective medical device alarm management, and continuous process improvement methods.

Compact planar antennas for short-range wireless automotive communication

This paper describes several small printed circuit board planar antennas that can be integrated with amplifiers for short-range vehicle wireless communication. The antennas are designed for the 315-MHz frequency band, which is commonly used for control and security devices in the USA and Canada. Each antenna has dimensions of 50 times 70 mm (much less than the free-space wavelength lambda=0.95 m) and is implemented on FR-4 dielectric substrate. These investigated antennas were compared with respect to input impedance, radiation resistance, radiation efficiency, directivity, directionality, bandwidth, matching system complexity, and gain. This paper also includes experimental verification of the final antenna design in the vehicle. It is shown that the antenna diversity method can increase communication range for remote keyless entry systems

Panel - the technological literacy of undergraduates: Developing standard models

This panel will report the results of a workshop and symposium on the technological literacy of undergraduates convened at the National Academy of Engineering (NAE) on March 26-27, 2007. The NAE advocates that all Americans become more knowledgeable about technology. Here technological literacy is defined as the broad understanding of all types of technological devices and process not just computers. The opportunity to utilize undergraduate education to further technological literacy of all students must not be neglected. Educators in computer science, engineering and technology have a responsibility to educate all students not just those intending technical careers. Despite the need for all Americans to become technologically literate, technical literacy is not likely to gain wide acceptance until the scholarly community develops standard courses that are supported by textbooks and other course materials. This National Science Foundation (NSF) sponsored workshop sought to identify and define several models of technological literacy courses. In this FIE panel, short presentations about these models will be made by participants in the NAE/NSF symposium. This will be followed by a discussion with the audience. A goal of the discussion will be to seek the input from FIE participants on the technological literacy course models.