J. D. Salinger Biography Essay

J. D. Salinger Biography Essay J.D Salisinger Biography J.D. Salinger was born in 1919 by a Christian mother and a Jewish father in the city of New York. Mr. Salinger entirely dedicated himself to writing after being enrolled at New York University and also at Columbia University. By the time Mr. Salinger was 21 years old; in 1940, he had had a chance to publish wide range short stories in periodicals, and this was being considered as a huge success in his life. During World War II, the career of Mr. Salinger as a writer was greatly disrupted but he was able to return from the service and continued as a writer, principally with The New Yorker, in 1946. He wrote for The New Yorker between 1948 and 1965 and published wide range of stories. For instance, in 1948 he published A Perfect Day for Banana-fish, which gives an account on the suicide of a desolated veteran of war. He also published For EsmeWith Love and Squalor in the year 1950, a story which gives an account of an encounter of a United States soldier together with two British child ren. Therefore, by the end of 1965, Mr. Salinger had published thirty-five different short stories. The Catcher in the Rye was published in the year 1951, and it is a publication that earned Mr. Salinger major significant and trendy acclaim. It was a story of Holden Caulfield, who was a disobedient boarding-school student who tries to escape from the world of adult that he normally finds it fake. As a creative writer and finding wayward for protagonist of a child, Mr. Salingers novel is given a great deal of sympathy. Work Cited Salinger Jerome David. The Catcher in the Rye. City of Westminster, London: Penguin Books, Limited, 2010.

Planet Taco A Global History Of Mexican Food - 1627 Words

This paper looks to define and explore three books which are a crux to various food histories which in the last decade has become a scholarly journey as food history is becoming increasingly studied as a scholarly endeavor by historians where previously it was not seen in such a scholarly light. The three texts which are going to be examined are: Planet Taco: A Global History of Mexican Food by Jeffery M. Pilcher, The Invention of the Restaurant: Paris and Modern Gastronomic Culture by Rebecca L. Spang, and lastly To Live and Dine in Dixie: The Evolution of Urban Food Culture in the Jim Crow South by Angela Jill Cooley. Each of these books seek to redefine how people see their perspective topics whether it be Mexican identity rooted in cuisine, the evolution of southern food in a racially divided south, or even the concept of the restaurant emerging from a revolutionary culture. These texts bring awareness to various topics which have both social, cultural, and economic stigmas as sociated with them. Planet Taco: A Global History of Mexican Food by Jeffery M. Pilcher, a Professor of History at the University of Minnesota, provides rather than a history of Mexican cuisine instead a changing of people’s culinary choices by investigating how people’s minds change over the course of decades in the presence of marketing strategies both domestic and international and changing consumer outlooks and tastes regarding foreign cuisine. Pilcher does this by using a seeminglyShow MoreRelatedPersuasive Speech : People Should Increase Their Intake Of Insects1485 Words   |  6 Pagesknown as entomophagy Central Idea: People should increase their intake of insects because of the many benefits that come along with it. I. Introduction A. 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Through this document, in the first part, we can learn about the Mexican history, also the facts of the influences that effected Mexican cuisine, the unique climate and geographyRead MoreImpacts of Globalisation on Pepsico3862 Words   |  16 Pageswith the Quaker Oats Company, creating the world’s fifth-largest food and Beverage Company. Today PepsiCo is a world leader in convenient snacks, foods and beverages with revenues of more than $60 billion and over 285,000 employees. With headquarters in Purchase, New York, the company consists of Frito-Lay North America, PepsiCo Beverages North America, PepsiCo International, Quaker Foods North America, Pepsi-Cola UK, Walkers snack Foods Limited and Pete amp; Johnny Plc. Their main businesses - Frito-LayRead MorePepsico Case8696 Words   |  35 Pagesand Socially Responsible Culture COMPANY OVERVIEW PepsiCo is one of the largest food and beverage companies in the world. 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Slave Trade Triangle free essay sample

What is the slave trade triangle? Slave Triangle- the three stages of the voyage that were made by slave trading ships: from Europe to Africa, from Africa to America and from America back to Europe between the 17th and 1 9th centuries. (It formed a triangular trade pattern, hence the name The Slave Triangle). Stage 1: In Africa, European slave traders bought enslaved Africans in exchange for goods shipped from Europe. Stage 2: Also called the Middle Passage. This was the part of the triangle where enslaved Africans were forcibly shipped across the AtlanticOcean to America. On reaching America, those Africans who had survived the journey were sold as slaves to work on plantations. Stage 3: The third and final part of the triangular slave trade was the return voyage from America to Europe. Slave ships returned to Europe loaded with goods produced on plantations using slave labor. It could take slave ships up to one year to complete the entire triangular voyage. We will write a custom essay sample on Slave Trade Triangle or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Why did the trade begin? Expanding European empires in the New World lacked one major resource a ark force.In most cases the indigenous peoples had proved unreliable (most of them were dying from diseases brought over from Europe), and Europeans were unsuited to the climate and suffered under tropical diseases. Africans, on the other hand, were excellent workers: they often had experience of agriculture and keeping cattle, they were used to a tropical climate, resistant to tropical diseases, and they could be worked very hard on plantations or in mines, so Africans would be excellent workers to handle he work of others so in order to assist them in their work Africans were kidnapped and forced to be made their slaves.In each of the stages items were given which was- The first stage of the Triangular Trade involved taking manufactured goods from Europe to Africa: cloth, spirit, tobacco, beads, cowries shells, metal goods, and guns. The guns were used to help expand empires and obtain more slaves (until they were finally used against European colonizers). These goods were exchanged for African slaves. The second stage of the Triangular Trade (the middle passage) involved shipping the slaves to the Americas.The third, and final, stage of the Triangular Trade involved the return to Europe with the produce from the slave-labor plantations: cotton, sugar, tobacco, molasses and rum. How did the Europeans obtain the slaves? Between 1450 and the end of the nineteenth century, slaves were obtained from along the west coast of Africa with the full and active co-operation of African kings and merchants. (There were occasional military campaigns organized by Europeans to capture slaves, especially by the Portuguese in what is now Angola, but this accounts for only a small percentage of the total. Conditions for slaves- Slaves were introduced to new diseases and suffered from malnutrition long before they reached the new w orld. It is suggested that the majority of deaths on the voyage across the Atlantic the middle passage occurred during the first couple of weeks and were a result of malnutrition and disease encountered during the forced marches and subsequent interment at slave camps on the coast.

Structures and Agency Essay Example

Structures and Agency Essay What is structure and agency? How does this framework help us in political analysis? For it is part and parcel of daily experience to feel both free and enchained, capable of shaping our own future and yet confronted by towering, seemingly impersonal constraints. Consequently in facing up to the problem of structure and agency social theorists are not just addressing crucial technical problems in the study of society, they are also confronting the most pressing social problem of the human condition. ’1 Structure and agency is a key understanding mechanism within social science. The approach attempts to answer the question of action; how is it that I can do what I want with others when their goals are different, and often incompatible with mine? Prominent social scientists including Giddens and Archer have suggested that the ‘Structure-Agency’ question is the most important theoretical issue within the human sciences. This debate has been slower to make an impact on political science than on some other social science disciplines yet it has been argued that structure-agency questions should be recognised as central to the way we study politics. It can be argued that there is no ‘escape’ from issues of structure-agency. Hay argues: â€Å"Every time we construct, however tentatively, a notion of social, political or economic causality we appeal, whether explicitly or (more likely) implicitly, to ideas about structure and agency. †2 The structure and agency can be regarded as crucial to an understanding of Social Sciences; it has at its base a fundamental question which humans have posed for a long time. This is an essentially normative question; are we free to act as we please, or are we shaped and governed by structures? We will write a custom essay sample on Structures and Agency specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Structures and Agency specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Structures and Agency specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Nobody would argue that structure controls us completely, but neither, in the post-modern world, are we completely free. It is prudent to first determine examine what we can understand by the terms ‘structure’ and ‘agency’. This paper will begin will deal with some definitions and summarise the position from both sides of the agency structure debate. By examining the case of the recent second Gulf War in Iraq, an analysis of the usefulness of the framework will be discussed to ascertain its validity in political analysis. The agency approach is sometimes twinned with methodological individualism, which argues that the only reality we can grasp is the deeds/actions of individuals, not classes. The approach suggests structural forces such as hegemony cannot be seen as real; they are intangible and thus we can say nothing provable about them. This implies an epistemology that we cannot look at classes to explain the behaviour of individuals. It is therefore quite a severe approach to the human sciences. Giddens suggests the actor is an embodied unit and as such, a possessor of causal powers that she may choose to employ to intervene (or not) into the ongoing sequence of events in the world. This makes her an agent. Giddens â€Å"†¦define[s] action or agency as the stream of actual or contemplated causal interventions of corporeal beings in the ongoing process of events-in-the-world. †3 It is analytical to the concept of agency that a person or agent â€Å"could have acted otherwise. †4 This conception of the agent ties agency to power. Agency approaches see the individual as atomized, positting a voluntarist approach to human action. They argue that the context in which an individual lives is a pluralism; social power is spread between groups, and that no single group dominates. The way to analyse, therefore, is by looking at what the individual tells us there is an onus on reflexivity; on the individual being able to account for and be aware of the reasons and implications of their actions. This approach also pays attention to time. History is taken to be the outcome of freely chosen choices and self-determined deeds: the great man view of history which sees Napoleon, Hitler, Mussolini, Margaret Thatcher and Bush as figures that, through freewill and behaviour, changed the course of history. Extreme versions of this thinking hold that explanation of this is beyond human understanding. Critics of this approach claim that this is metaphysical although structure approaches give us a very one-dimensional view. Individualists would argue that we are richer as human beings than structure approach theories can predict. This is an overview of agency approaches, which are often lumped together with conservatism, claiming that there is freedom and that we succeed or fail by our own qualities and actions. Structure is essentially explanation in terms of the social/economic/political context in which action occurs. Structuralists deny that the human actor is the ultimate social reality, focussing instead on the situated human actor. Key concepts in this focus are emplacement and embodiment. A structure approach is often associated with the political left and theorists such as Smith and Marx. It argues that because conditions change through time and space then the great man theory doesnt work. Structuralist approaches recognise that there are specific conditions which produce human actions or behaviour. Essentially individuals are believed not to be atomised but acting as a result and through the constraints and structures in which they exist. Behaviour is then not a result of free will but a product of structural factors. In positing reasons for behaviour, you are beginning a structure approach: explaining action according to the structure/context in which it takes place. A structure approach would hold that individuals are situated actors in place and embodiment. We are embodied physically, defining out health, opportunities, life possibilities, etc. , and emplaced in terms of lifestyle, conditions, etc. Our actions therefore respond to the structures of one kind or another, in which we are situated. Another way of thinking about how structure changes us comes from the 19th century social scientist, Durkheim. An example comes from Durkheims work on suicide, which listed three categories in which suicide could occur: Egoistic: for reasons of self-dissatisfaction or in response to personal emotion. Altruistic: for the good of other people Anomic: because all structures have broken down and life no longer has meaning This shows that even in relation to this extreme decision, the individual does not act without reasons – reasons are taken in response to structures. Durkheims theory of social facts clarifies the relationship between structure and infrastructure. Structures have priority, externality and constrain, in relation to our behaviour. Structuralists reject pluralism: they argue that the atomized actor is the only actor we can know. We can therefore predict life chances according to structures such as class, race and gender. From a structuralist approach we can understand the relevance of the debate to politics. Structuralist Marxists would argue that human action and choice is determined by class. Society is composed of superstructure, what we can call civil society which includes things such as education, the arts and culture and substructure which is constituted of the material and economic base. Marx argued that the substructure defines the superstructure – clearly a structuralist and deterministic view of society and culture. Both levels, according to Marx, are controlled by a ruling class. Men make their own history, but not under circumstances of their own choosing. Marcuse, for example, argues that we do not live in a free society, but a one-dimensional one. There is no freedom, simply reproduction of the views of the ruling class. Similarly, structuralist feminism, of the 1960s, held patriarchy as the key structural influence. The work of Germaine Greer and Kate Millet reflects this. They saw the systematic exclusion and subordination of women from many aspects of the economy and society, and explained the position and behaviour of women through the structures set up by men. There are criticisms of this approach. Firstly, structuralist accounts underestimate the reflexivity and autonomy of human actions. They tend to concentrate on the individuals position in a hierarchy, and do not deal with the ambiguity and ambivalence of human experience. There is a skewed reality at work: they attribute too much power/influence to few structures. Marxists, for example, have been accused by feminists of ignoring gender as a structure. Furthermore, they postulate repetitive patterns of behaviour and therefore cannot explain how changes, for example Glasnost and the abandonment of Communism have occurred. Loyal and Barnes elucidate the key differences between structure and agency. They suggest â€Å"agency stands for ‘the freedom of the contingently acting subject over and against the constraints that are thought to derive from enduring social structures. To the extent that human beings have agency, they may act independently of and in opposition to structural constraints, and/or may (re)constitute social structures through their freely chosen actions. To the extent that they lack agency, human beings are conceived of as automata, following the dictates of social structures and exercising no choice in what they do. That, at any rate, is the commonest way of contrasting agency and structure in the context of what has become known as the structure/agency debate. †5 No current theorists would argue that either agency or structure are completely in control of our behaviour, although much is still influenced by this debate: most people today hold the view that agency and structure are enmeshed together. It is still a debate which informs how we think and research. A consequence of the abandonment of extreme positions is the new prevalence of postmodern thought, for which structure is no longer the complete answer. Stuart Hall, for example, admitted in the 1980s that we are living in new times, not defined by class, as in the Marxist approach of his work. Feminists have also accepted that patriarchy is not the sole reason for womens behaviour. Postmodernism has filled the vacuum. Postmodernism reflects the ambiguity and ambivalence of life, and suggests that structures such as class are discursive, representations of how life occurs, not real life. This is a thread in the work of Baudrillard, Barthes, Foucault and Derrida. Derridas work, for example, foregrounds the play of meaning in his differance which implies defer and differ. The point is that meaning is always deferred: there is never a final truth or fact, and reality is always being rewritten. This radically destabilises the idea of a shared reality, emphasising the elasticity of human experience and the need to look at life processually. Everything is moving, unfixed, unfastened, and there are no underlying fixed structures. Postmodernism also emphasises the need to be tolerant of other peoples viewpoints. It encourages multiculturalism. Another strand is Hybridity theory, which claims that everything is hybrid in some sense: that there is no purity. Consequently, no language or point of view is superior. â€Å"Giddens in the form of what he calls ‘Structuration’ theory has set out to try and transcend the dualism of structure and agency. His basic argument is that, rather than representing different phenomena, they are mutually dependent and internally related. 6 Structure only exists through agency and agents have ‘rules and resources’ between them which will facilitate or constrain their actions. These actions, can lead, in turn, to the reconstitution of the structure, defined as rules and resources, which will, in turn, affect future action. Thus, we have a close interrelationship between structure and agency. Giddens’ metaphor for this is that rather than being dist inct phenomena structure and agency are in fact two sides of the same coin. As such, we have a conception of the mutual constitution of structure and agency. As Taylor argues, â€Å"†¦this conception is the most distinctive feature of ‘Structuration’ theory, yet a feature which serves crucially to undermine the theory as a whole. †7 This approach combines the best of agency and structure approaches the actor is situated, but not clueless. This emphasises reflexivity, and assumes a high degree of self-awareness on the part of the actor, but also allows for the influence of structures and awareness of emplacement. Structuration theory is Giddens attempt to bridge the gap between theories which place emphasis on either structure or agency at the expense of the other. Structuralism represents one extreme on a continuum of theory in which social structures such as class, gender or race are seen as systems which are so pervasive through time and space that people have little or no choice but to operate within them. At the other end of the continuum, there is an emphasis is on the subjective individual, structures are seen as ephemeral; they are relative and secondary to agency. These extremes can be characterized as systems without actors in the case of the former, and actors without systems in the case of the latter. Giddens explains the relation between theses two extremes by offering a theory of structuration that: â€Å"†¦provide[s] an account of human agency which recognizes that human beings are purposive actors, who virtually all the time know what they are doing (under some description) and why. At the same time [as understanding that] the actions of each individual are embedded in social contexts stretching away from his or her activities and which causally influence their nature. 8 Grasping the recursive nature of social practices the duality of structure – is according to Giddens, the key to achieving this. The study of politics largely concerns conceptions of power; ‘who gets what, when and how. ’9 We can understand the role of the state to include controlling and distributing limited resources which determines who benefits, and is included, and who does not benefit and is excluded. Structure and agency can assign responsibility for political actions; it is t he head of state or the political-economic environment that causes events and change? An acknowledgement of the structure agency debate allows us to acknowledge the influence of structures and agents in the political world. The structure agency debate cannot be seen as an approach to political analysis in the same way that rational choice theory might be. However, it is an important way of considering and analysing issues. Let us examine for example, the cause of the Second Gulf War in Iraq. Structure and agency debates will examine this with the approach of; were the actors involved free to make decisions independently of structures and so, as individuals, change the course of history? Or was it a situation in which structure was the predominant factor and the actions of the individuals involved was pre-ordained? From an agency perspective, there are clearly two actors who made key decisions which led to the conflict; George Bush and Saddam Hussein. We can understand that George Bush may have been inclined to go to war as he was simply following in his father’s footsteps, attempting to finish off his father’s unfinished business and trying to consolidate American hegemony. Similarly, we can see that Saddam Hussein was responsible for the conflict by his continued refusal to allow weapons inspectors to sites and his recalcitrance to convince the world that they were not harbouring terrorism and producing weapons of mass destruction. On the structure side of the debate we can see that there were factors of structure; Bush and Hussein were individuals acting in accordance with the structures they themselves may have been unaware of, so that these actors were situated in an environment which meant the course of action was inevitable. Some structural factors that could be considered would be; rising oil prices which, had they continued would have undoubtedly fuelled the recession and increased US domestic stability. Furthermore, instability in the region and the history of Iraqi development of banned weapons and expelled weapons inspectors meant that in a structural sense, there was a sense of inevitability of the conflict. The issue of hegemony could also be regarded as a structuralist consideration as it pervades both economy and culture; it is the field on which the game is played. In providing an explanatory framework for political analysis, postmodernism is largely defunct. Postmodernist accounts of structure and agency reduce it to a discourse in which structure and agency are no more than arbitrary discursive constructs. In the case of war in Iraq we can see that this is a gross oversimplification. However, we can clearly see that these phenomena – Saddam, Bush, oil, terrorism and political stability are very much ‘out there’ with their own characteristics and properties. Structure and agency can produce social effect without being articulated in discourse. Furthermore, Giddens’ rejection of the dualism of structure and agency, regarding it as two sides of the same, replies to the criticism of dualistic constructs. The dialectical approach, and in particular, Giddens’ structuration theory provides a plausible explanation which, as Giddens elucidates, the two sides of the same coin. In the case aforementioned, this constructs a much more plausible explanation which takes into consideration all factors involved. Giddens suggests ‘systems’, in this case, the political climate, influence people’s actions, but in turn, social contexts, or ‘structures’ continue to exist only if they are sustained by people’s repeated actions, for example the actions of Bush and Saddam. â€Å"Giddens concept of the ‘duality of structure’ melds agency and structure into one instead of regarding them as a dualism that consists of two separable albeit connected phenomena; unless and until structure is instantiated it has only virtual existence in the form of memory traces in people’s minds. †10 To conclude, the structure-agency debate is useful insofar as it provides a framework within which to explain social change; and to attribute causation, and this is what Giddens recognises in his two sided coin analogy. Giddens is right that we can only see one side of the coin at a time; this results from our own perceptual limitations when we trying to interpret phenomena. Political theory needs abstraction and over-simplification of the world to enable us to explain phenomena and change; the structure agency debate is one tool to enable us to do this.

Free Essays on The Destructors

â€Å"The Destructors† is a great example of a good kid gone bad. The main character displays knowledge and leadership skills but does not have an opportunity to put them to good use. For this reason, Trevor is a victim of society. The story takes place in London shortly after the end of World War II.. The protagonist in the story is Trevor. His father lost his job as an architect in the high class society where his family has lived all of their life. The family was forced to move into less expensive housing. His son Trevor had troubles adapting to the change. Trevor soon made friends around his neighborhood and became a member of the Wormsley Common Gang. Early on, the other boys could tell that he did not fit in. The gang made fun of his name, Trevor, because it was typically an upper class name and unheard of where they lived. Trevor adapted and demanded that they call him â€Å"T.† Trevor gained the favor of the other gang members when he told them his plan to tear down Mr. Thomas’ house. Trevor had been inside the house before and used his knowledge of architecture that he learned from his father to devise a plan to tear the house down from the inside out. The gang was successful and build a reputation for themselves. Revenge against the upperclass is the underlying theme of the story. To understand why, we must first make an important distinction between the upper and lower class. The upper class have better education and are given the opportunity to create, whereas the lower class do not have these norms, which causes anomie and results in an adverse affect of a child’s development. It is easier for the upper class to strive because their lifestyle encompasses opportunities that gives them the ability to create a positive environment for their family. The children are nurtured in this environment and are given a chance to grow. However, the lower class children are not born into such an environment. They generally have ... Free Essays on The Destructors Free Essays on The Destructors â€Å"The Destructors† is a great example of a good kid gone bad. The main character displays knowledge and leadership skills but does not have an opportunity to put them to good use. For this reason, Trevor is a victim of society. The story takes place in London shortly after the end of World War II.. The protagonist in the story is Trevor. His father lost his job as an architect in the high class society where his family has lived all of their life. The family was forced to move into less expensive housing. His son Trevor had troubles adapting to the change. Trevor soon made friends around his neighborhood and became a member of the Wormsley Common Gang. Early on, the other boys could tell that he did not fit in. The gang made fun of his name, Trevor, because it was typically an upper class name and unheard of where they lived. Trevor adapted and demanded that they call him â€Å"T.† Trevor gained the favor of the other gang members when he told them his plan to tear down Mr. Thomas’ house. Trevor had been inside the house before and used his knowledge of architecture that he learned from his father to devise a plan to tear the house down from the inside out. The gang was successful and build a reputation for themselves. Revenge against the upperclass is the underlying theme of the story. To understand why, we must first make an important distinction between the upper and lower class. The upper class have better education and are given the opportunity to create, whereas the lower class do not have these norms, which causes anomie and results in an adverse affect of a child’s development. It is easier for the upper class to strive because their lifestyle encompasses opportunities that gives them the ability to create a positive environment for their family. The children are nurtured in this environment and are given a chance to grow. However, the lower class children are not born into such an environment. They generally have ...

Sir Robert Peel and Modern Day Police

Sir Robert Peel and Modern Day Police Free Online Research Papers The early roots of policing encompassing Sir Robert Peel’s nine principles have a distinct application to modern day policing. It is important to understand the genesis of policing and the development prior to Sir Robert’s codification of the role of police in the 1820’s. Prior to 1829, law enforcement in England and America had principally been in the hands of ordinary citizen volunteers, night watchmen, sheriffs, or constables. It was generally unorganized and informal in its application. As early as 1215, with the acceptance of the Magna Carta in England, the first serious interest to solve abuse at the hand of the policing authority and for the general maintenance of order originated. Peel recognized these same problems and suggested solutions to the traditional problems of recruitment of qualified policemen, a uniform application of penalties for official misconduct, and the creation of an independent method of control of the police. These issues had been debated for centuries but with the introduction of these principles Peel started the ultimate professionalization of modern police management. The purpose of this paper is to illustrate the connection between Sir Robert Peel’s nine principles and their connection to modern policing. Any attempt to understand a connection to the nine principles Peel espoused requires a brief description as depicted by the New Westminister Police Service. The first principle states that basic reason for having a police force is to prevent crime and disorder. The second principle suggests that police must have public approval to be effective. Third, the police must secure the willing cooperation of the public to obey the law in order to have the respect of the public. Next, the degree of cooperation from the public declines with the use of force. Fifth, the police secure public favor by observing impartial service to the law. Sixth, the police must use force only after exhausting all other means to obtain compliance. Seventh, the police are members of the public who are discharging their official duty to secure the welfare of t he public. Eighth, the police enforce laws and do not exercise the right to impose punishment. Last, the measure of police effectiveness is in the absence of crime and disorder and not just police activity. The growth of American policing is closely related to the English legal traditions. However, the American police developed under different circumstances, despite the similarities with the English. Three major characteristics that mirror the English system are principles of limited authority, local control, and fragmented organization. Sir Robert Peel, as Home Secretary in the British Cabinet, recognized the major failings of the prevailing policing practices and successfully orchestrated the passage of the Metropolitan Police Act of 1829. This was the Act that ultimately created the London Police Force. It provided for a uniformly recruited, organized, paid, professional police force that we would recognize as very similar to those seen today. Further, the Metropolitan Police Act authorized Sir Robert to establish the police force with the quick recruitment of one thousand men in what would resemble military regiments. Sir Robert and his subordinates, known as commissioners, were faced with many obstacles with regard to organization and management of the new force. These problems are the same faced by modern Chiefs of Police. They include the thoroughness of training of police recruits, aptitude, maturity, and suitability of candidates, and the standardization of policy, discipline, and the maintenance of community relations. The stage for modern American policing was set in the 1830s following the English model. Large and diverse urban centers, similar to those in England’s industrialized areas, contributed to the growth of professional police beginning in New York and Boston. The presence of social disorder forced the civil governments to take action, albeit slowly and with some suspicion of uniformed agents in the civil setting. The influence of Sir Robert’s principles was felt and progress was substantial in the Northeastern States. This was in contrast to the role of law enforcement in the Southern and Western states. The various geographical areas of the United States evolved differently and can still be seen in the philosophical approached used by modern police agencies. The effect of the nine principles took hold in distinct phases of American History up to the present day. The first, the Political Era (1840-1920), showed the shortcoming of contemporary policing due to political interference and official corruption. It was probably the most substantial obstacle to Peel’s reforms. Political machines generally influenced hiring, salary, and even investigative activities. The Professional Model Era (1920-1970) recognized the shortfalls of previous era and focused on hiring competent, qualified applicants and in curbing police abuses and inefficiency. The most changes occurred during the 1960s primarily due to civil rights abuses. From 1970 to the present the police focus has been called the Community Model Era which has sought to put the police into more contact with the public it supports and to improve quality of police through higher standards. The evolution of modern day policing has had many failed attempts and false starts since the early Nineteenth Century and Peel’s principles. While the principles represent an idealized vision of police activity, they have served as a touchstone for modern law enforcement theorists and criminologists. The concept of community policing can be attributed to Sir Robert Peel in the sense that his principles form the core of police-community interaction. References Cole, George Smith, Christopher. (2004). The American System of Criminal Justice. Toronto, Ontario, Canada, Wadsworth. Cromwell, Paul Dunham, Roger. (1997). Crime and Justice in America. Research Papers on Sir Robert Peel and Modern Day PoliceUnreasonable Searches and SeizuresThe Fifth Horseman19 Century Society: A Deeply Divided EraThe Relationship Between Delinquency and Drug UseOpen Architechture a white paperBringing Democracy to AfricaThe Project Managment Office SystemCanaanite Influence on the Early Israelite ReligionPETSTEL analysis of IndiaThe Effects of Illegal Immigration

History and Laws of Abortion in the US Research Paper

History and Laws of Abortion in the US - Research Paper Example Abortion has always been a controversial but frequently performed practice in nearly all parts of the world whether it is legal or not. Despite all the moral considerations, abortions were performed legally before 1880 in United States of America. After that most of the states banned the practice with the exception of the case for saving a mother’s life. Anti-abortionist movements, politics, and birth control efforts facilitated anti-abortionist or restrictive legislation throughout history. However, the case of Roe v. Wade and Supreme Court’s decision turned the history in favor of abortion forever in 1973.The abortion history before and after Roe v. Wade is entirely different. The law legalized the practice throughout United States considering it the privacy and right of a woman. The paper explores the history of abortion and laws involved with special emphasis on 1973 Roe v. Wade case. According to Webster’s New International Pocket Dictionary 1998,â€Å"The expulsion of a fetus prematurely, miscarriage, the defective result of a premature birth; a monstrosity, and a person or thing that fails to progress or develop normally or as expected† (as cited in Krieg, 1999, p.4).On the other hand, Webster’s New International Pocket Medical & First Aid Dictionary, 1998 refers abortion as, â€Å"The ultimate termination of a pregnancy, either by natural or artificial means† (as cited in Krieg, 1999, p.4). In United States, Abortions became legal after Supreme Court’s decision of the case Roe v. Wade in 1973.But the history of abortions dates back to the time when earliest settlers of this land arrived. In American colonies, English â€Å"Common Law† was adopted that prohibited abortion. It was considered a â€Å"misdemeanor† if performed before â€Å"quickening† while after quickening, it was considered to be â€Å"felony†. In early 1800s, the discovery about conception and

An aging report - visiting the elderly Coursework

An aging report - visiting the elderly - Coursework Example I had interviewed an elderly male, 75 years old, widowed and still mobile with minimal assistance, living in an apartment with his son. Due to confidentiality of information, client’s identity was not stated.He does not take a bath everyday for he feels cold although he wanted to.He believed taking a bath everyday would actually help alleviate the roughness of his skin.When permission was sought to see his bed room for observation purposes Client X wore loose and free-flowing white t-shirt and pajamas. He indicated that his sleeping position needed frequent changing as advised by his doctor to avoid pressure sores. Likewise, it was also recommended to massage his bony prominences. Observing his physical appearance, one noticed that his nails were properly trimmed, he wore eyeglasses and dentures. Based on the following observations, the physical status and appearance of the client manifested changes expected of an elderly (Udan, 8). He can take care of his personal needs excep t in urination and meal preparation. His son’s wife provides him meals. He strongly believes that his wellness is due to his son’s commitment to bring him to the clinic for regular check-up. Expressing his outlook verbally was a difficult task for him. He revealed that lots of people feel bored because he spoke slowly. Aside from that, some people had to repeat their words or shout because of hearing impairment. As a consequence, I was advised to put some of my instructions in writing. When asked about his plans for the future, he projected a melancholy appearance as he averred, â€Å"I think there’s no future left for me. At this age, I only think of the time when I can no longer be with my son. Of course, everybody fears death. And if there’s something I dream and hope for, that is to see my grandchildren before I die and for my son’s family to have a better life.† Then, we talked about his activities and lifestyle for a week. He said that it is very routine and predictable. During weekdays, he would go out with his son in the morning to exercise his feet and legs. After that, they would go back to their house and spend the day for preparing for diverse tasks such as watching television shows, doing easy exercises, reading and undergoing light but entertaining activities that would enhance mental and motor skills. At night, he sleeps early but the quality of sleep is light, intermittent, with frequent waking. On Sundays, he looks forward to attending mass and sharing special dinner with his son’s family. With these activities, going out without a companion could not be possible because walking through the transportation area tires him a lot. Although he needed assistance in terms of mobility, he was never inactive. He also stated that in his age, he considered himself healthy. A wellness center for the elderly within the community assists in his health care. Using the five dimensions of person model, certain n eeds that an elderly should meet (Udan, 11-13) were proffered and manifested by Client X. Under physical dimension, Client X accepted that having gray hair and wrinkles were normal parts of aging. He acknowledged looking old and have learned to accept that fact. His strength and stamina decreased; most of the time, he needed assistance. â€Å"I told you before that I have difficulty hearing, but it doesn’t stop me from expressing my ideas,† he stated. Client X understood the risks of being prone to different diseases involving the vital organs (e.g., pneumonia, diabetes, kidney diseases) that rationalized regular check-ups and observing preventive measures. In terms of intellectual dimension, the client manifested the ability to remember. There were some lapses but he managed using a calendar note to assist in doing tasks. He acknowledged to have the ability to solve problems, make decisions despite being aware that learning new information takes time. â€Å"

Hunger Games Survival Essay Example for Free

Hunger Games Survival Essay The game is designed to kill you. From the first moment when you are dropped into the merciless jungle, you are actively trying to be killed. Forgetting the band of other survivors that are effortlessly searching for you, there are many terrors you must be ready for. To prepare for these, you must have a good shelter, a way to find food and water, and a positive mental attitude. A shelter is arguably the most important of the 10 essentials in survival. Without a shelter, you could get soaking in rain or snow, and subsequently, die from the moisture. You will get bitterly cold during the night and die in your sleep. So Katness knew she needed a good shelter. One that would keep her warm and dry, as well as mobile. She built two kinds of shelter; one was high in a tree, both to protect her from the indigenous, and to keep her off of the moist ground. She knew that sitting directly on cold or snow covered ground will increase the rate of heat loss drastically. So even in the tree, she put her jacket below her and her towel above her protect her from the elements, both below her and above her. The second shelter she built was a makeshift debris hut. She found the base of a huge redwoody type of tree, which provided a stable back and added protection from snowfall and climate protection. She, one again, added a blanket to the floor as well as many ribs on her debris hut and foliage both for camouflage and climate protection. Finding food and water in this Amazonian jungle proved difficult. As two of the ten essentials, food and water are necessary in survival. Luckily, she brought enough nutrient rich power bars with her to surpass the amount of time she needed to. She was also aware to not over work, and keep a 60% rule when searching so her power bars would be sufficient. Finding water, was much more difficult. Water is scarce in many jungle environments, so she had to take little bits of snow in a bottle and let it melt over time and drink it. Eating straight snow will actually make you thirstier than without it, good thing she new that. Even with a stable shelter, a substantial food and water supply, and a sense of safety, she was still finding it difficult to keep a positive mental attitude, or PMA. Without a positive mental attitude, someone in a survival situation could lose hope of being found or surviving the night, and could just die. That is why she does simple activities to keep a PMA. She thinks about here friends and family back home, her boyfriend who is also stuck in this jungle, and other activities to keep her motivated and keep her striving to survive this unfortunate event. Due to her knowledge of the 10 essentials, knowing how to build a shelter, and the power to keep a positive mental attitude, Katness made it out of this treacherous situation. This may have been a movie, but this is a real world situation that anyone could have found themselves in. The opportunity to learn about the 10 essentials, or how to build an adequate debris hut, is an opportunity that you do not want to miss. These life-saving tips have not only helped Katness make it out of the Hunger Games, but it may also help you make it out of a life or death situation of your own.

Kenneth Branaughs Hamlet or William Shakespeares Hamlet? Essay

Kenneth Branaugh's Hamlet or William Shakespeare's Hamlet? Kenneth Branaugh may have had the script of William Shakespeare's Hamlet spoken down to every last thee and thou, but one must remember that this is Hamlet through Branaugh's eyes, not Shakespeare's. Therefore, dismissing obvious additions made for adapting the play to film, such as having a real castle instead of a stage, it is possible to observe the unique characters, interpretations, actions, and setting that make this version the director's own.   Ã‚  Ã‚  Ã‚  Ã‚  In the time of Shakespeare, one of the actors main challenges was to use the words to paint the scene for the audience, since, for the most part, they were looking at a bare stage. However, this use of imagination and portrayal is no longer needed when the script is brought to film. Every pearl and snowflake have been placed strategically before the audience, so that there is no need to listen to the language to create your own vision of Hamlet's world. Branaugh's world is full of lavish affairs, freezing winters, and halls of mirrors. The use of the camera has some definite advantages and disadvantages. First, since the characters are no longer limited by a defined space, they are able to deliver their long speeches while being in a constant state of motion. This occurs in the scene with the guards, and most noticeably in the scene with Laertes and Ophelia, before he leaves for France. This same scene demonstrates how the camera enables the characters to switch from one setting to the next, as when Laertes, Ophelia, and Polonius are taken from outside to the church. This, in turn, helps Branaugh set the scene for Ophelia and Polonius, in which, Ophelia confesses everything to her father, perhaps only because she is in a confession booth. Filming also allows for clarification of what is being said through silent plays. During characters' dialogue, the scene switches to actions of the past, present, and even to things that could happen. This seems to be used to give the audience a better understanding of what is happening, and it also helps to further develop the characters so that the story is built up to the audience, rather then being tossed into the middle of the storyline. Young Fortinbras is often shown in these silent plays and is the only way his character is able to be developed to such an extent. This technique is... ...h Hamlet being carried out in a cross formation, perhaps suggesting that Hamlet's pursuit of vengeance was his crucifixion.   Ã‚  Ã‚  Ã‚  Ã‚  There are so many ways this work can be interpreted and acted out, and that makes it hard to be critical when there is no standard to compare it to. This film was Kenneth Branaugh's vision of Hamlet, and so to him it is magnificent. To myself, this film had many brilliant spots and was very thorough and well acted out. However, at times, the action and music became a bit overwhelming. Perhaps Branaugh got a little to caught up in the moment, it is hard to say. The silent plays that were shown throughout ( King Hamlet's death, the drowned Ophelia, Hamlet's childhood days with Yurich, Priam's slaughter, Fortinbras) added a lot to the film, because it gave the characters a history and allowed for a non-shakespearean audience to better understand what was being said. The adaptation from play to film is not always very easy, and obviously some changes have to occur. Branaugh's version of Hamlet definitely had some additions, but it still captured the essence of Shakespeare making it an interesting piece of work, and an enjoyable film.

Night World : Spellbinder Chapter 5

What?† Thea said. This was something she could speak out about. â€Å"Blaise, are you out of your mind?† â€Å"I hope you're not saying you don't want to do spells,† Blaise said dangerously. â€Å"That's part of it, you know.† â€Å"I'm saying there's no way we can get enough blood to fill this without them noticing. What are we going to tell them? ‘I just want a little to remember you by?'† â€Å"Use your ingenuity,† Vivienne said musically, twining a red-gold strand of hair around her fingers. â€Å"In a pinch we could always use the Cup of Lethe,† Blaise added calmly. â€Å"Then no matter what we do, they won't remember.† Thea nearly fell over. What Blaise was suggesting was like using a nuclear bomb to swat a fly. â€Å"You are crazy,† she said quietly. â€Å"You know that maidens aren't allowed to use that kind of spell, and we probably won't even be able to use it when we're mothers, and probably not even when we're crones. That's stuff for the elders.† She stared at Blaise until the gray eyes dropped. â€Å"I don't believe in classifying some spells as forbidden,† Blaise said loftily, but she didn't look back at Thea and she didn't pursue the subject. As she and Dani left the patio, Thea noticed that Dani had taken one of the small vials. â€Å"Are you going to the dance?† â€Å"I guess so.† Dani shrugged lithe shoulders. â€Å"John Finkelstein from our world lit class asked me a couple weeks ago. I've never been to one of their dances before-but maybe this is the time to start.† Now what did that mean? Thea felt uneasy. â€Å"And you're planning to put a spell on him?† â€Å"You mean this?† She twisted the vial in her fingers. â€Å"I don't know. I figured I'd take it just in case†¦.† She looked up at Thea defensively. â€Å"You took one for Eric.† Thea hesitated. She hadn't talked to Dani about Eric yet. Part of her wanted to and part of her was scared. What did Dani really think of Outsiders, anyway? â€Å"After all,† Dani said, her sweet face tranquil, â€Å"they're only humans.† Saturday night Thea took a dress out of the closet. It was pale green-so pale that it almost looked white-and designed along Grecian lines. Witch clothes had to feel good as well as look good, and this dress was soft and lightweight, swirling beautifully when she turned. Blaise wasn't wearing a dress. She was wearing a tuxedo. It had a red silk bow tie and cummerbund and it looked fantastic on her. This is probably going to be the only dance in history where the most popular girl has on cufflinks, Thea thought. Eric arrived right on time. He knocked at the front door of the shop, the door that only Outsiders used. Night People came around back, to a door that was unmarked except for what looked like a bit of graffiti-a spray-painted black dahlia. Okay, Thea thought. She took a deep breath before she unlocked the door and let him in. This is business, business, business†¦. But the first moment wasn't as awkward as she'd feared. He smiled and held out a corsage of white orchids. She smiled and took it. Then she said, â€Å"You look nice.† His suit was pale fatigue brown, loose and comfortable looking. â€Å"Me? You look nice. I mean-you look wonderful. That color makes your hair look just like gold.† Then he glanced down at himself apologetically. â€Å"I don't go to many dances, I'm afraid.† â€Å"Don't you?† She'd heard girls talking about him at school. It seemed as if everyone liked him, wanted to get close to him. â€Å"No, I'm usually pretty busy. You know, working, playing sports.† He added more softly, â€Å"And I have a hard time thinking of things to say around girls.† Funny, you never seem to have a problem around me, Thea thought. She saw him looking the shop over. â€Å"It's my grandmother's store. She sells all kinds of things here, from all around the world.† She watched him closely. This was an important test. If he-a human-believed in this stuff, he was either a New Age geek or dangerously close to the truth. â€Å"It's cool,† he said, and she was happy to see that he was lying. â€Å"I mean,† he said, obviously struggling to find a polite way to praise the voodoo dolls and wand crystals, â€Å"I think people can really affect their bodies by changing their state of mind.† You don't know how right you are, Thea thought. There was a clack of high heels on wood, and Blaise came down the stairs. Her shoes appeared first, then her fitted trouser legs, then all the curves, emphasized here and there with brilliant red silk. Finally came her shoulders and head, her midnight hair half up and half down, framing her face in stormy dark curls. Thea glanced sideways at Eric. He was smiling at Blaise, but not in the goofy, dying-sheep way other guys smiled. His was just a genuine grin. â€Å"Hi, Blaise,† he said. â€Å"Going to the dance? We can take you if you need a lift.† Blaise stopped dead. Then she gave him a blistering glare. â€Å"Thank you, I have my own date. I'm just going to pick him up now.† On the way to the door, she looked hard at Thea. â€Å"You do have everything you need for tonight- don't you?† The vial was in Thea's pale green clutch purse. Thea still didn't know how she could possibly get it filled, but she nodded tightly. â€Å"Good.† Blaise swept out and got into a silver-gray Porsche that was parked at the curb. Kevin's car. But, as Thea knew, she wasn't going to pick up Kevin. â€Å"I think I made her mad,† Eric said. â€Å"Don't worry. Blaise likes being mad. Should we go now?† Business, business, business, Thea chanted to herself as they walked into the school cafeteria. It had been completely transformed from its daytime identity. The lights and music were oddly thrilling and the whirl of color out on the dance floor was strangely inviting. I'm not here to have fun, Thea told herself again. But her blood seemed to be sparkling. She saw Eric glance at her conspiratorially and she could almost feel what he was feeling-as if they were two kids standing hand in hand at the edge of some incredible carnival. â€Å"Uh, I should tell you,† Eric said. â€Å"I can't really dance-except for slow ones.† Oh, great. But of course this was what she was here to do. To put on a show of romancing Eric for Blaise. A slow song was starting that minute. Thea shut her eyes briefly and resigned herself to fate-which didn't seem all that awful as she and Eric stepped out onto the floor. Terpsichore, Muse of the Dance, help me not make a fool of myself. She'd never been so close to a human boy, and she'd never tried to dance to human music. But Eric didn't seem to notice her lack of experience. â€Å"You know, I can't believe this,† he said. His arms were around her lightly, almost reverently. As if he were afraid she'd break if he held her too hard. â€Å"What can't you believe?† â€Å"Well†¦Ã¢â‚¬  He shook his head. â€Å"Everything, I guess. That I'm here with you. And that it all feels so easy. And that you always smell so good.† Thea laughed in spite of herself. â€Å"I didn't use any yemonja this time-† she began, and then she almost bit her tongue. Adrenaline washed over her in a wave of painful tingles. Was she crazy? She was blurting out spell ingredients, for Earth's sake. He was too easy to talk to, that was the problem. Every so often she'd forget he wasn't a witch. â€Å"You okay?† he said as her silence stretched on. His voice was concerned. No, I am not okay. I've got Blaise on one side and the laws of the Night World on the other, and they're both out to get me. And I don't even know if you're worth it†¦. â€Å"Can I ask you something?† she said abruptly. â€Å"Why did you knock me out of the way of that snake?† â€Å"Huh? It was in a striking coil. You could have got bit.† â€Å"But so could you.† So did you. He frowned as if stricken by one of those unsolvable mysteries of life. â€Å"Yeah†¦ but that didn't seem so bad somehow. I suppose that sounds stupid.† Thea didn't know how to answer. And she was suddenly in terrible conflict about what to do. Her body seemed to want her to lean her head against Eric's shoulder, but her mind was yelling in alarm at the very thought. At that moment she heard loud voices at the edge of the dance floor. â€Å"Get out of the way,† a guy in a blue jacket was saying. â€Å"She smiled at me, and I'm going over there.† â€Å"It was me she was smiling at, you jerk,† a guy in a gray jacket snapped back. â€Å"So just back off and let me go.† Expletives. â€Å"It was me, and you'd better get out of the way.† More expletives. â€Å"It was me, and you'd better let go.† A fistfight started. Chaperones came running. Guess who's here? Thea asked herself. She had no trouble at all locating Blaise. The red-trimmed tuxedo was surrounded by a ring of guys, which was surrounded by a ring of abandoned and angry girls. â€Å"Maybe we should go over and say hi,† Thea said. She wanted to warn Blaise about starting a riot. â€Å"Okay. She sure is popular, isn't she?† They managed to worm their way through the encircling crowd. Blaise was in her element, glorying in the adulation and confusion. â€Å"I waited for an hour and a half, but you never showed up,† a very pale Kevin was saying to her. He was wearing an immaculate white silk shirt and exquisitely tailored black pants. His eyes were hollow. â€Å"Maybe you gave me the wrong address,† Blaise said thoughtfully. â€Å"I couldn't find your house.† She had her hand tucked into the arm of a very tall guy with shoulder-length blond hair, who looked as if he worked out four or five hours a day. â€Å"Anyway, you want to dance?† Kevin looked at the blond guy, who looked back impassively, his cleft chin rock hard. â€Å"Don't mind Sergio,† Blaise said. â€Å"He was just keeping me company. Do you not want to dance?† Kevin's eyes fell. â€Å"Well, yeah, of course I want to†¦.† As Blaise detached herself from Sergio, Thea leaned forward. â€Å"You'd better not do anything too public,† she hissed in her cousin's ear. â€Å"There's already been one fight.† Blaise just gave her an amused glance and took Kevin's arm. Most of the boys followed her, and with the crowd gone, Thea saw Dani at a small table. She was wearing a sparkling gold dress and she was alone. â€Å"Let's go sit,† Eric said, before Thea could even get a word out. She threw him a grateful look. â€Å"Where's John?† Thea asked as they pulled chairs to the table. Dani nodded toward the pack following Blaise. â€Å"I don't mind, though,† she said, sipping a cup of punch philosophically. â€Å"He was kind of boring. I don't know about all this dance stuff.† Thea knew she meant it was different from Circle dances, where everyone was in harmony and there was no pairing off. You danced with the elements and with everybody else, all one big interconnected whole. Eric volunteered to get more punch. â€Å"How's it going with him?† Dani asked in a low voice when he was gone. Her velvety dark eyes searched Thea's curiously. â€Å"Everything's okay so far,† Thea said evasively. Then she looked out toward the dance floor. â€Å"I see Viv and Selene are here.† â€Å"Yeah. I think Vivienne already got her blood. She stabbed Tyrone with her corsage pin.† â€Å"How clever,† Thea said. Vivienne was wearing a black dress that made her hair look like flame, and Selene was in deep violet that showed off her blondness. They both seemed to be having a wonderful time. Dani yawned. â€Å"I think I'll probably go home early-† she began, and then she broke off. Some kind of a disturbance had begun on the other side of the room, in front of the main entrance. People were scuffling. At first, Thea thought it was just another minor fracas over Blaise-but then a figure came staggering out under the lights of the dance floor. â€Å"I want to know,† the voice said in dissonant tones that rose over the music. â€Å"I want to knoooow.† The band stopped. People turned. Something about the voice made them do that. It was so obviously abnormal, the cadence wrong even for somebody who was drunk. This was someone who was disturbed. Thea stood up. â€Å"I want to knoooow,† the figure said again, sounding lost and petulant. Then it turned and Thea felt ice down her spine. The person was wearing a Halloween mask. A kid's plastic mask of a football player, the kind held on with an elastic string. Perfectly appropriate for a Halloween dance. But at Homecoming, it was grotesque. Oh, Eileithyia, Thea thought. â€Å"Can you tell me?† the figure asked a short girl in black ruffles. She backed away, reaching for her dance partner. Mr. Adkins, Thea's physics teacher, came jogging up, his tie fluttering. None of the other chaperones seemed to be around-probably because they were out somewhere trying to control fights over Blaise, Thea thought. â€Å"Okay, let's settle; settle,† Mr. Adkins said, making motions as if the figure were an unruly class. â€Å"Let's just take it easy†¦.† The guy in the Halloween mask pulled something out of his jacket. It glinted like a rainbow under the colored dance floor lights, reflective as a mirror. â€Å"A straight razor,† Dani said in a hushed voice. â€Å"Queen Ms, where'd he get that?† Something about the weapon-maybe the fact that it was so weird, so old-fashioned-made it scarier than a knife. Thea pictured the way even a safety razor could slice flesh. Mr. Adkins was backing away, arms held out as if to protect the students behind him. His eyes were frightened. I have to stop this, Thea thought. The problem was that she had no idea how. If it had been an animal, she could have stepped out and tried mind control. But she couldn't control a person. She started walking anyway, slowly, so as not to attract attention. She skirted the edge of the crowd around the dance floor until she drew parallel with the masked guy. Who by now had switched to a new question. â€Å"Have you seen her?† he said. He kept asking it as he walked, and people kept backing away. Vivienne and Selene drew to either side with their dates. The razor glittered. Thea looked toward the opposite end of the dance floor, where Blaise was standing with Kevin Imamura. With no Buck, no Duane to protect her. But Blaise didn't look frightened. That was one thing about Blaise-she had magnificent physical courage. She was standing with one hand on her hip and Thea could tell that she knew exactly who was coming her way. In between moving couples, Thea glimpsed something else. Eric was on the other side of the dance floor, holding two cups of punch in one hand and one in the other. He was keeping pace with the masked guy, just as she was. She tried to catch his eye, but the crowd was too thick. â€Å"Have you seen her?† the masked guy asked a couple right in front of Blaise. â€Å"I want to knoooow†¦.† The couple split like bowling pins. Blaise stood exposed, tall and elegant in her black suit, lights shimmering off her midnight hair. â€Å"Here I am, Randy,† she said. â€Å"What is it you want to know?† Randy Marik stopped, panting. His breath made a muffled noise against the plastic. The rest of the huge room was eerily silent. Thea moved closer, walking silently. Eric was pulling in from the other side, and he saw her for the first time. He shook his head at her and mouthed, â€Å"Stay away.† Yeah. And you're going to tackle him armed with three party cups of punch. She gave him a look and mouthed, â€Å"You stay away.† Randy's hand was trembling, making the razor flash. His chest was heaving. â€Å"What is it, Randy?† Blaise said. The toe of one high heeled shoe tapped the floor impatiently. â€Å"I feel bad,† Randy said. It was almost a moan. Suddenly his head didn't seem well connected to his neck. â€Å"I miss you.† His voice made Thea's flesh creep. He sounded like a person with the body of an eighteen-year-old and the mind of a four-year-old. â€Å"I cry all the time,† he said. With his left hand, he pulled off the Halloween mask. Kevin recoiled. Thea herself felt a wave of horror. He was crying blood. Bloody streams ran down from each of his eyes, mingling with regular tears. A spell? Thea wondered. Then she thought, no; he's cut himself. That was it. He'd made two crescent-shaped incisions under his eyes and the blood was coming from them. The rest of his face was ghastly, too. He was white as a corpse and there was fuzzy stubble on his chin. His eyes stared wildly. And his hair, which had always been strawberry blond and silky, stood up all over his head like bleached hay. â€Å"You came all the way from New Hampshire to tell me that?† Blaise said. She rolled her eyes. Randy let out a sobbing breath. This seemed to make Kevin braver. â€Å"Look, man, I don't know who you are-but you'd better keep away from her,† he said. â€Å"Why don't you go home and sober up?† It was a mistake. The wild eyes above the bloodstained cheeks focused on him. â€Å"Who are you?† Randy said thickly, advancing a step. â€Å"Who†¦ are†¦ you?† â€Å"Kevin, move!† Thea said urgently. It was too late. The hand with the razor flashed out, lightning quick. Blood spurted from Kevin's face.

Critical Care Sound Environments Health And Social Care Essay

ABSTRACT. Intensive attention units in infirmaries take attention of critically sick patients under really nerve-racking conditions. A turning literature is demoing that intensive attention units ( ICUs ) are frequently really noisy and frequently transcending World Health Organization ( WHO ) guidelines1,2. However few surveies have linked more elaborate analyses of the sound environment, such as mean sound force per unit area degrees, transient sound degrees, and spectral distribution, to nurse well-being and public presentation. This survey differs from old surveies in several ways. Namely, we have studied the possible impact of layout design applications on the features of ICU sound environments. This was accomplished by comparing the subjective and nonsubjective qualities of two ICU sound environments with different layout designs. Furthermore, the survey included: 1 ) detailed nonsubjective and subjective noise degree measurings at multiple locations in each of the two units st udied, and 2 ) analysis of the association between the aim and subjective noise degrees via different statistical trials, including analysis of the impact of the ICU sound environments on sensed nurse results.I. IntroductionThe sound environments of ICUs are aurally demanding while nurses endeavor to put to death complex undertakings. It hence becomes of import to understand the acceptable and unacceptable subjective and nonsubjective qualities of the ICU sound environments from the nurses` point of position. In this survey, we believe nurses ‘ perceptual experience of their workplace sound environment is critical for the rating of undertaking and nurse well-being supportive ICU sound environments. By matching the subjective perceptual experience measurings with nonsubjective sound degree measurings, we can derive a more thorough appreciation of how physical and perceptual acoustic parametric quantities interact in the ICU scene. In order to cast visible radiation on these con cerns, we focused on the undermentioned research inquiries in this comparative research survey: 1 ) Do nonsubjective noise degrees differ: ( a ) between assorted locations within an single critical attention unit? ( B ) when comparing similar locations in the two critical attention units to each other? ( degree Celsius ) when comparing overall ( mean ) degrees in the two critical attention units to each other? ; 2 ) Do nurses` noise-induced irritation and loudness perceptual experience differ: ( a ) between assorted locations within an single critical attention unit? ( B ) when comparing similar locations in the two critical attention units to each other? ; 3 ) Does the sensed impact of overall noise degrees in the workplace on subjective nurse wellbeing and work public presentation differ when comparing two units to each other? ; 4 ) Is there a relationship between aim and subjective noise degrees? ; 5 ) Is there a relationship between noise degrees and noise-induced nurse results? II. PREVIOUS RESEARCHA. Overview of Hospital Acousticss1. ResultsThe acoustic environment in infirmaries can impact all residents, including staff, patients, and visitants. The undermentioned treatment in relation to the focal point of this survey is largely limited to the effects of noise on staff members: emphasis and irritation ; work public presentation ; wellness results and work overload. Information about how hospital acoustics may impact patients and visitants can be found in beginnings such as Bush-Vishniac et Al. 2 and Ryherd et al.3. The staff ‘s well-being, efficiency and effectivity in presenting attention and executing critical undertakings is critical to maximise patient safety, satisfaction, and attention quality in ICUs. Stress-annoyance: Intensive care unit are nerve-racking attention scenes that can be exacerbated by the centripetal overload caused by environmental factors, including the acoustic environment. Stress is the person ‘s assessment of a mis match between perceived demand and perceived self-capabilities to get by 4. Depending on the badness and continuance, it may take to illness ( i.e. , elevated blood force per unit area, dyspepsia ) , behavioural alterations ( i.e, unhappiness, depression, negative attitudes ) . Anxiety is a psychological responses to environmental stimulations or activity bring forthing rousing 5. Excessive anxiousness degrees can take to upsets. Like anxiousness, irritation is one of the early psychological responses which reflects the unwantedness of the environment stimuli 6. Irritation relates to the invasion of a stimulation on a mental or physical activity. In one survey, higher mean sound force per unit area degrees predicted higher sensed emphasis, and perceived irritation degrees in a Pediatric-ICU 7. In another survey, less sensitiveness to resound and greater personality robustness ( such as committedness, control, and challenge ) were linked with less noise-induced emphasis 8. In the same survey, ICUs nurses working eight-hour eventide displacements reported that they were significantly distressed by noise. There is some grounds that high noise degrees in attention scenes contribute to staff emphasis and irritation. However, the figure of noise-induced nurse emphasis surveies conducted in the ICUs is really limited. Work public presentation: Hospital sound environments that are supportive of infirmary undertakings could potentially better staff effectivity in presenting attention. Improved nurse work public presentation in ICUs can forestall inauspicious events, better health care quality, and optimise resource use. The survey fou nd that noise in the workplace was perceived to hold a negative impact on staff work public presentation and concentration 3. A Neonatal-ICU survey showed that sound that exceeds 55dBA most of the clip can potentially interfere with work. This multidisciplinary literature reappraisal survey highlighted that undertakings necessitating rapid reaction clip and watchfulness are sensitive to resound. Noise-induced work public presentation research has been more normally conducted in the operating theatres 9-11. The impact of noise on staff public presentation ( particularly in ICUs ) has non been widely examined. Health results: The acoustic environment throughout the infirmary may lend to negative ague or chronic symptoms in staff. Critical attention nursing is a really demanding occupation and it requires uninterrupted watchfulness, watchfulness, and wellbeing to carry on critical undertakings efficaciously. The survey found that of the 47 ICU nurses surveyed in an ICU, reported annoya nce, weariness and concerns due to workplace noise 3. The earlier mentioned survey besides showed that addition in mean sound degrees was significantly related to an addition in bosom rate 7. Elevated bosom rate can tie in with cardiovascular harm particularly in hypertensive persons 12. Noise-induced hearing loss has been the concern for executing sawboness in the operating theatres 13,14. However, noise-induced wellness results ( including hearing loss ) of ICU nurses` have non yet been the focal point of hospital noise literature. Work overload: Work overload can be critically of import for overall wellbeing of staff. Poor acoustical conditions in workplaces can worsen staff attitude and perceived work overload. When noise degrees exceed a nurse ‘s get bying abilities it can take to centripetal overload 6. Centripetal overload can do emotional exhaustion, dissatisfaction, and decreased sense of personal achievement. This in bend can do feelings of ineffectualness, awkwardne ss, low satisfaction, and perceived deficiency of success 15. In one survey, it was found that medicine mistake and other inauspicious events necessary for patient safety were associated with emotional exhaustion and staff burnout 16. In another survey it was besides found that nurse emphasis due to ICU noise was positively related to nurse emotional exhaustion and burnout17. Hagerman et Al. showed that in a coronary bosom unit enhanced acoustical conditions such as decreased echo clip and improved address intelligibility improved staff attitude perceived by patients 18. The limited bing grounds points to a important job that should be investigated farther to find appropriate acoustic conditions that will minimise negative work overload effects.2. Acoustic prosodiesThere is a turning organic structure of literature on infirmary noise. Many of those surveies focus on qualifying overall noise degrees in a assortment of hospital infinites including ICU ‘s, but few of them focuses specifically on ICU staff response 3. A assortment of different methods have been used in qualifying the infirmary sound environment. The grounds of these methodological analysis differences are non good known 3 but may be related to motivations such as single penchants, practicality, common sense, convenience, the degree of proficient expertness, etc. ( 1 ) Overall noise degree steps: These steps have been preferred most normally. This may be based on their practicality and convenience, in add-on to their incorporation into assorted guidelines such as WHO. Leq, Lmin, Lmax and Lpeak sound degrees can supply a general overview of the sound environment, but they remain limited for the elaborate analysis of the sound environment. ( a ) Leq: It enables the speedy comparing of the noise degrees with recommended values and those in other types of infinites. Therefore, it might be widely accepted as to be the primary step to depict a sound environment. This might besides happen in relatio n to the degree of proficient expertness required to show some penetration about more elaborate features of the sound environment. However, this common belief can be misdirecting about the truth and adequateness of the usage of chiefly Leq degrees. ( B ) Lmax, Lpeak and Lmin: The highest and the lowest values measured over clip provide more information about the overall noise degree fluctuations. In most instances, these steps are conventionally used to depict infirmary sound environments. However, these values remain unidimensional and level to depict the general tendency in sound environment. ( 2 ) Detailed noise degree steps: To counterbalance the restrictions of the overall sound steps, the usage of extra acoustic prosodies is critical for the elaborate analysis of the sound environment. Compared to above mentioned sound steps, Ln percentile ( Ln ) , echo clip ( RT ) , speech intelligibility ( SI ) , and the spectral content such as frequence analysis and noise standards steps h ave been less normally used. Hospital acoustic research has been the involvement of different research groups such as medical groups and proficient groups. Based on the group ‘s proficient expertness on the subject, some acoustic prosodies might hold been preferred to the others. ( a ) Sound quality related steps: In the ICUs, there is diverseness of noise beginnings such as dismaies, HVAC systems, conversation and medical equipment. Those noise beginnings generate noises with different frequences and sound forms. Ln percentiles and spectral content analysis become of import for elaborate analysis of fluctuations, tonic content, spectral distribution, and other features in the noise degrees over clip. ( B ) Speech quality related steps: Some other specific features of the infirmary room acoustic environment have been described with the usage of extra acoustic prosodies such as SI and RT. To construe the intervention of the infirmary noise degrees and room conditions with criti cal medical communications, SI has been used. To stand for the degree of drawn-out being of noises that can perchance overlap and interfere or dissemble the other sounds, RT has been used.3. Measuring ICU sound environmentsMethods applied during the sound sample aggregations can hold important impact on the appraisal of the infirmary sound environments. There has non been a widely accepted understanding about how the sound samples should be collected to qualify the complex and dynamic ICU sound environments in close propinquity to occupant experience 3. However there has been some consensus on a few methodological considerations among different ICU-noise surveies such as locations where sound informations collected in the attention scenes. Noise degrees in the ICU patient suites have been normally documented. Sound recordings took topographic point either in a representative patient room 3,19,20 or in more than one patient room with different characteristics such as distance to the nurse station, occupied-empty, figure of patient beds 2,7,21-28. There was a good understanding on the location of the sound metre: every bit near as possible to patient caput – to capture what the patient hears- while avoiding any intervention with nurse work flow. Hanging the mike from the top of the medical tower in the patient room has been introduced as a practical solution 3. Different continuances were preferred for the aggregation of sound samples such as 168hr, 72hr, 24hr, and 8hr at patient locations. Among those, 24hr entering period was more widely accepted than others. A few ICU-noise surveies have conducted different continuance noise degree measurings at the nurse Stationss such as 24hr and 168hr 2,26,27. Busch-Vishniac et Al. described the sound environment of one more puting – hallways- in their survey and placed the metre at the room centre 2. Largely the merchandises of two companies have been preferred to mensurate sound degrees: Larson Davis and Br uel & A ; Kj?r. It was non a common attack to document the sound metre scenes used. Much of the noise degree measurings were conducted based on slow response clip ( 1sec ) as suggested by Occupational Safety and Health ( OSHA ) for typical occupational noise measurings 2,28,29. Some surveies used fast response clip ( 0.125sec ) as suggested by WHO 3,21. When recorded based on fast response clip, more fluctuations can be expected in the sound degrees. The penchants among averaging intervals varied and ranged between 5sec and 24hr ( i.e. 30sec, 1min, 5minaˆÂ ¦etc. ) . Among ICU-noise surveies the usage of 1min averaging interval was more common likely because it enables a more elaborate expression to the clip history informations. Sound recordings were normally analyzed as a map of clip. Day clip and dark clip mean sound degrees were normally reported. Among the reviewed ICU-noise surveies, non many of them were conducted during the weekends but during the weekdays. Morrison et A l. and Ryherd et Al. considered twenty-four hours and dark clip based on 12s hr nurse displacements ( twenty-four hours time:7am-7pm ; dark clip: 7pm-7am ) 3,7. MacKenzie and Galbrun considered the twenty-four hours and dark clip periods based on WHO guidelines ( 16hour twenty-four hours time:7am-11pm ; 8hr dark time:11pm-7am ) 21. In drumhead, consistence of the methodological penchants in infirmary acoustics research can be really helpful for the dependability of the comparings between the consequences of different surveies.III. METHODOLOGYPutingThe research was conducted in two intensive attention units ( ICU ) at Emory University Hospital. Neurological ICU ( Neuro-ICU ) is a late opened 20- bed unit ( Fig. 2 ) . This unit received the â€Å" ICU Design Citation † award in 2008 for its design purpose to heighten the critical attention environment for patients, households and clinicians. Some unit design features include big private patient suites with household studio, dis trusted nurse work countries and care support countries and a scope of noise cut downing applications. High public presentation absorbent acoustic ceiling tiles and bead ceiling applications reside chiefly along the two parallel sides of the corridors and at the nurse Stationss, painted dry wall, vinyl flooring and 6ft broad ( two-wing ) glass patient room doors are some of the surface applications in the unit. Patient attention nucleus of the Neuro-ICU sits about on 19,000sqft. This nursing floor has a bunch type layout. The layout is composed of a six- bed and fourteen- bed bunchs. Each bunch has a cardinal nurse station with its ain attention support countries ( e.g. medicine room, supply roomaˆÂ ¦etc ) and computerized patient monitoring system. In entire, the unit has two cardinal nurse Stationss and 17 distributed nurse work countries. Approximately one-third of the 390sqft patient room is segregated from the patient attention country by a semi-opaque glass wall and good equipped for household demands. Approximately one-third of the patient attention nucleus floor country is occupied by the corridors. The length of the corridors is 600ft. Entire Neuro-ICU includes extra infinites such as public household countries, CT scan lab, and a curative garden. With all these infinites, the entire Neuro-ICU sits about on 24,000sqft. The Medical Surgical ICU ( MedSurg-ICU ) is a 1980s epoch twenty-bed unit ( Fig. 1 ) . Compared to the other unit, MedSurg-ICU has a more traditional physical environment with ceiling tile, vinyl flooring, 5ft broad ( two-wing ) glass patient door and painted dry wall surface applications. Patient attention nucleus of this unit sits about on 8,800sqft. The nursing floor has a triangular form race path layout design – medical and support countries are located in the centre and patient suites are located on the margin and the corridor separates these two infinite types. Twenty private patient suites are organized around one big triangular form service hub. This hub contains two patient monitoring cores – each serves to ten patients- at the corners and a centralised attention support country. Patient suites in this unit are about 190sqft and equipped with a Television like the patient suites in the other unit. This peculiar layout type requires the usage of unintegrated co rridors for staff and household members. Approximately, one-quarter of the patient attention nucleus floor country is occupied by the staff corridor. The length of the staff corridor is 240ft. Entire MedSurg ICU including the household corridor environing the unit, sits about on 12,500sqft. In contrast to the physical environment differences, both units apply similar staffing theoretical accounts with intensivists and nurse practicians and suit critical attention patients with similar sharp-sightedness degrees. In both units, by and large ten to twelve registered nurses are working during each displacement. The Neuro-ICU nurses largely work 12-hr displacements ( 7am-7pm, 7pm-7am ) ; the MedSurg-ICU nurses besides work 8-hr displacements ( 7am-3pm, 3pm-11pm, and 11pm-7am ) . In both units, nurses can work either at the weekend or during the weekdays or both ; during the twenty-four hours clip or dark clip or both.Measures1. SoundObjective and subjective noise degree measurings in two units were conducted during two back-to-back months. In both units, same processs were applied. Objective noise degree measurings were conducted at four different locations in each unit: centralised nurse station, empty patient room, occupied patient suites with and without respiratory venti lator and multiple informations points in the corridors. A sum of 96-hr uninterrupted stationary noise degree measuring was conducted at the nurse station of each unit from Thursday to Monday. Saturday and Sunday was deliberately included as it has non been much addressed in the literature. In each unit, 24-hr uninterrupted stationary sound degree measurings were conducted in the occupied patient suites without respiratory ventilator during a weekday. In relation to limited entree, merely 45-min sound samples were collected from the occupied patient suites with respiratory ventilator. Similarly in each unit, 45-min uninterrupted stationary sound degree measuring was conducted an empty patient room while patient room doors were closed. At the corridors, multiple 15-min sound samples were collected at indiscriminately selected times during twenty-four hours and dark. In entire, about 246-hr sound informations was collected from both units. For the computation of overall noise degrees in each unit, all sound informations collected at different locations were taken into consideration. Medical equipment dismaies happening in the patient suites, patient proctor dismaies happening both in the patient suites and at the nurse Stationss, sound of the ice machine engine, phone ring, staff conversation, turn overing medical carts in the corridors were some of the common noises in two units. In MedSurg-ICU nurses are paged via overhead beepers. In Neuro-ICU 3G-phones or regular phones at the baies are used alternatively. At the corridors, the mike was located at a tallness of 4.5ft somewhat off the room centre and stabilized on a tripod. In the patient room, the mike was hanged from the ceiling at a tallness of 6ft. The distance between the patient ‘s caput and the mike was minimized every bit much as possible. Similarly, mike was hanged from the ceiling at the nurse station at a tallness of 6ft. In Neuro-ICU, the sound metre was set up at the nurse station of fourteen-bed side. In MedSurg-ICU, sound metre was located at somewhat off the centre of the cardinal nurse work zone in the centre of the unit. Sound information was collected utilizing a fast response clip for upper limit and lower limit degrees ( 0.125 s ) as recommended by World Health Organization ( Berglund and Lindvall 1999 ) . Three Larson Davis-type 824 sound degree metres were used and collected informations was downloaded via Larson Davis 824 Utility package. For unattended field measurings, two Lockable Larson Davis outdoor me asurement instances were used. . For safety intents, 50ft mike extension overseas telegram was run from each outdoor sound metre instance to the walls and eventually to the mark point on the ceiling. The out-of-door noise measuring instance was placed carefully at a topographic point out of the nurse manner. Before any installing effort, proposed locations for the arrangement of sound metre at different locations in the units were approved by the charge nurse. One-minute averaging interval was used. One-third octave set informations was obtained. The dynamic scope was 80dB un-weighted from floor-38dB to overload-118dB.2. Self-reportAn electronic study was administered to 90 and 60 five registered nurses working in Neuro-ICU and MedSurg-ICU severally. Nurses were contacted via electronic mail by the nurse pedagogue of each unit and they gave their consents online. The study consisted of four subdivisions: nurse profile and working conditions, perceived sound environment in the workpl ace, perceived impact of noise degrees on nurse results, general hearing wellness and noise sensitiveness. Survey response rate was 39 % and 35 % in Neuro-ICU and MedSurg-ICU severally. In Neuro-ICU, 85 % of the nurses participated in the survey was full clip and 15 % was portion clip nurses. In MedSurg-ICU, 70 % of the nurses participated in the survey was full clip ; 26 % was portion clip and the remainder was PRN. In two units more than 80 % of the nurse population was female. Similarly, in both units more than 80 % of the nurses were younger than fifty old ages old.IV. ResultA. Objective noise degrees1. Make nonsubjective noise degrees differ when comparing overall ( mean ) degrees in the two critical attention units to each other?Noise degrees measured at multiple different locations in each unit are averaged for the computation overall noise degrees including Leq ( assumed name ) , Lmax ( dubnium ) , Lpeak ( dBC ) and Lmin ( dubnium ) . Those locations are: nurse station empty patient room, corridors and occupied patient suites with and without the respiratory ventilator. To clear up, in order to spread out the sample size, measurings conducted in the occupied patient room with ventilator were besides considered in the computation of overall noise degrees for each unit. In MedSurg ICU and Neuro-ICU overall averaged Leq, LMax, LMin and LPeak noise degrees ranged between 57-58dBA, 105-97dB, 57.5-54dB, and 120-113dBC severally. Detailed consequences are shown in Fig. 2. For elucidation intents, in this paper the term â€Å" averaged † does non reflect the calculation methods used but refers to the consideration of multiple measurings in the computation of individual noise degree. More elaborate analysis consequences are shown in Fig. 3. This chart represents the per centum of clip that different degree unprompted sounds ( LFMax ) in the scenes exceeded peculiar noise degrees. This type analysis consequences are referred as â€Å" happening rate â₠¬  in this paper. In both units more than 98 % of the clip LMax noise degrees exceeded 70dB. It was more than 96 % of clip that LPeak noise degrees exceeded 80dBC in both units. Finally, it is possible to reason, the difference between overall averaged LAeq degrees in Neuro-ICU and MedSurg ICU are unperceivable. Information about perceptual experience of alteration in sound intensivity can be found in Mehta et al 30. However elaborate noise degree measurings indicated significant differences. The sound environments of two units are different based on the happening rate of the impulse sounds at high noise degrees.2. Make nonsubjective noise degrees differ when comparing similar locations in the two critical attention units to each other?A-weighted mean sound force per unit area degrees ranged between 52-60dB and 45-56 dubnium at four different locations in MedSurg-ICU and Neuro-ICU severally ( Fig. 4 ) . Those four locations were nurse station, occupied patient room without respirat ory ventilator, empty patient room and the corridor. In both units, patients with respiratory failure are connected to respiratory ventilator and most of those patients are under isolation which restricts the entries and activities in the patient suites. It was possible to carry on comprehensive measurings in the patient room without respiratory ventilator. Therefore, measurings conducted in the occupied patient room without respiratory ventilator was considered for location particular more elaborate noise degree analysis. At all four locations, LMax degrees exceeded 70dB about full clip in both units. Except empty patient room, at all other locations LMax noise degrees exceeded 80dB more than 36 % of the clip In MedSurg ICU and 11 % of the clip in Neuro-ICU. In general, noise degrees and happening rate of high degree impulse sounds was higher in MedSurg-ICU. Average sound force per unit area degree ( LAeq ) differences between nurse Stationss, occupied patient suites and the corrid ors of two units were either unperceivable or merely perceptible ( Fig. 4 ) . However LAeq noise degree difference between two units` empty patient suites was significant. LMax happening rates were dramatically different from each at other locations. Happening rates occurred at the nurse Stationss are shown in Fig. 5 as an illustration. However LMax happening rates did non differ dramatically in the empty patient suites ( Fig. 6 ) . LPeak happening rate analysis showed really similar consequences to LMax happening rate consequences.3. Make nonsubjective noise degrees differ between assorted locations within an single critical attention unit?In MedSurg-ICU and Neuro-ICU, overall noise degrees and happening rates of impulse sounds was much lower in the empty patient suites compared to other locations ( Table I ) . Occurrence rate of LPeak & gt ; 90dBC was systematically higher at the nurse station compared to other locations in both units. However, noise degree differences between nur se station and other locations were non ever perceptible based on differences between A-weighted Leq degrees.B. Subjective noise degrees1. Make nurses` noise-induced irritation and loudness perceptual experience differ between assorted locations within an single critical attention unit?In MedSurg-ICU, perceived loudness degrees at the nurse station were significantly higher ( p & lt ; 0.05 higher ) than other three locations harmonizing to nonparametric significance trial consequences. Average degrees of subjective irritation and volume are shown in Table II. Similarly, in Neuro-ICU perceived volume and irritation degrees in the empty patient room were significantly less ( P & lt ; .05 ) than other three locations.2. Make nurses` noise-induced irritation and loudness perceptual experience differ when comparing similar locations in the two critical attention units to each other?At all four locations – the nurse station, in the empty and occupied patient room and at the corrido rs perceived irritation and volume degrees of MedSurg-ICU nurses were systematically higher than the sensed degrees reported by Neuro-ICU nurses ( Table II ) . MedSurg ICU nurses perceptual experience of noise-induced irritation and volume at four locations ranged between 2.25 and 4.1.Same sensed degrees ranged between 1.6 and 3.2 among Neuro-ICU nurses. Additionally, nonparametric Mann-Whitney U trial consequences showed that noise-induced irritation and loudness perceptual experiences of nurses at the nurse Stationss and in the empty patient suites was significantly different in two units. Two unit nurses` sensitiveness to resound and tolerance to high noise degrees in the workplace did non differ significantly ( p & gt ; .05 ) . Overall, nurses were non really sensitive to resound and they could digest high noise degrees slightly.3. Does the sensed impact of overall noise degrees in the workplace on subjective nurse wellbeing and work public presentation differ when comparing two units to each other?A ­Perceived negative impact of workplace noise degree on five nurse result was reported higher by MedSurg-ICU nurses compared to Neuro-ICU nurses. MedSurg-ICU and Neuro-ICU nurses` responses ranged between 3-4.3 and 1.7-3 severally ( Table III ) . Overall, MedSurg-ICU sound environment was perceived systematically worse for nurse well-being and work public presentation compared to Neuro-ICU sound environment. Harmonizing to nonparametric significance trial consequences, all perceived five noise-induced nurse results differed significantly in two units.C. Correlations1. Is at that place a relationship between aim and subjective noise degrees?Spearman nonparametric correlativity trial was used to analyse the relationship between aim and subjective noise degrees. Overall and individually analyzed MedSurg-ICU and Neuro-ICU subjective and nonsubjective noise degrees systematically represent the being of a important relationship between subjective and nonsubjective noise degrees ( Table IV ) . Subjective noise-induced irritation and volume degrees are significantly and positively correlated with A-weighted mean sound force per unit area degrees and happening rate of impulse sounds happening at high degrees.2. Is at that place a relationship between noise degrees and noise-induced nurse results?Overall, subjective volume degrees are significantly and positively correlated with sensed noise-induced irritation, work public presentation, wellness and anxiousness ( p & lt ; .01 ) .D. Spectral content1. Frequency distribution of noise degreesOverall, sound force per unit area degrees were higher in MedSurg-ICU at low, mid and high frequence scopes ( 250Hz-8kHz ) ( Fig. 7 ) . At all locations but empty patient room, noise degree differences across frequences were largely either merely perceptible or unperceivable. At 8kHz clearly noticeable noise degree differences occurred between two unit nurse Stationss and occupied patient suites. At 250Hz and 5 00Hz, clearly noticeable and significant noise degree differences occurred between empty patient suites. Below 250Hz, sound force per unit area degrees were largely higher in Neuro-ICU ( Fig. 8 ) . In the empty and occupied patient room, noise degree differences at 16Hz were significant otherwise it was either merely perceptible or clearly noticeable. This happening might be related with the busyness noise generated by the HVAC engine located in the unfastened infinite in Neuro-ICU. This unfastened infinite about located in the centre of the unit and is non accessible by the residents but included in the design to supply natural visible radiation for some patient suites.2. Room Criteria ( RC ) analysisIn MedSurg-ICU, RC values were higher. However, RC evaluations were largely hissy and vibrational in Neuro-ICU while it was chiefly impersonal and non vibrational in MedSurg-ICU ( Table V ) .E. Fluctuation clipF. Speech Interference LevelIn general, speech intervention degrees in MedSu rg-ICU were higher at all four locations analyzed compared to Neuro-ICU. At the nurse Stationss, address intervention degrees ( SIL ) of the noise were highest and ranged between 50-53dB ( Table VI ) . Two female nurses will be able to ( hardly ) communicate with each other in normal voice up to a distance of about 3-4ft. Same distance ranged between 5.5-7.5ft if nurses raise their voices. Slightly lower SIL values occurred in the occupied patient room and in the corridors. Lower SIL degrees can enable safer communications from longer distances. Furthermore, compared to females, males in general are able to pass on better at longer distances.G. HVAC background noise degreesBackground noise degrees caused by HVAC systems were calculated based on steady 15-min sound samples collected in the empty patient suites. Sound force per unit area degrees across three frequences ( 500Hz, 1000Hz, 2000Hz ) were averaged every minute. In Neuro-ICU, HVAC noise degrees in the patient room were accep table harmonizing to American Society of Heating Refrigerating and Air-Conditioning Engineers ( ASHRAE ) recommended RC values, 25-35dB in the private suites 31. In Neuro-ICU, RC values ranged between 29-31dB. In MedSurg-ICU HVAC noise degrees in the patient room were higher than ASHRAE recommended values and ranged between 37-38dB in MedSurg-ICU.V. DISCUSSIONOne of the purposes of this survey is to lend to the on-going attempts to better health care sound environments. These attempts can enable more comprehensive analysis of helter-skelter health care sound environments. The survey findings discussed in this subdivision can supply some penetration for the appraisal of the bing and development of intelligence acoustic prosodies that might be necessary for more elaborate survey of the infirmary sound environments.1. Appraisal of overall ( mean ) vs. elaborate noise degree steps and their relation to subjective noise degreesOverall nonsubjective sound environment of two units were sig nificantly different based on elaborate noise degree measurings. Happening rate analysis is referred as elaborate noise degree measuring as it reflects the behaviour of impulse sounds during every minute. Statistically important differences between subjective noise-induced nurse results and loudness perceptual experience of MedSurg-ICU and Neuro-ICU nurses were consistent with the important differences between happening rates of impulse sounds ( LFMax, LCPeak ) that occurred at high degrees. Furthermore, nonparametric correlativity coefficient trial consequences indicated the being of a important and positive relationship between perceived irritation and volume degrees and happening rates of impulse sounds. However, overall noise degree measurings ( i.e LFMax, LCPeak, LFMin, LAeq ) particularly overall mean sound force per unit area degree did non bespeak perceptible differences between the sound environment of two units. Similarly, elaborate nonsubjective noise degree measurings be sides suggested important differences when comparing similar unprompted sound environments ( i.e. nurse station, occupied patient room and corridors ) in two units. Unlike detailed measurement consequences, overall mean sound force per unit area degree differences indicated either merely perceptible or unperceivable differences between similar locations in two units.2. Appraisal of stationary vs. unprompted sound environments and their relation to subjective noise degreesLocation specific subjective noise degree analysis ( i.e. perceived noise degrees at the nurse Stationss, in the empty and occupied patient suites and corridors ) indicated that MedSurg-ICU nurses` noise-induced irritation and loudness perceptual experiences were systematically higher than Neuro-ICU nurses` perceptual experiences. Particularly, subjective irritation and volume degrees differed significantly at the nurse Stationss and in the empty patient suites of two units. Nurse Stationss have unprompted sound env ironments where major sound beginnings are medical dismaies, telephone ring, staff laugh and talkaˆÂ ¦etc. Subjective noise degree differences between two unit nurse Stationss were consistent with important differences between happening rates of impulse sounds ( LFMax, LCPeak ) at the nurse Stationss. Unlike nurse Stationss, doors closed empty patient suites have stationary sound environments where chief noise beginning was the HVAC system. This clip, subjective differences between two unit empty patient suites were consistent with important differences between A-weighted mean sound force per unit area degrees measured in the empty patient suites. Furthermore, nonparametric correlativity coefficient trial consequences indicated the being of a important and positive relationship between perceived irritation and volume degrees and mean sound force per unit area degrees.3. Fluctuation clip and subjective noise degrees4. Features of infirmary sound environments and layout design ap plicationsAbove mentioned consequences confirms the earlier findings that suggest the being of a relationship between aim and subjective noise degrees. The theoretical account reviewed here suggests that different infirmary layout design applications can chair the relationship between aim and subjective noise degrees. Two unit nurses reported sensed effectivity of different layout design applications to cut down noise degrees based on their experiences and observations. Overall, three chief layout design applications were found effectual. Those were private patient suites, segregated corridor system and a unit with baies and centralised nurse station instead than a unit with merely centralised nurse station32. Private patient suites can diminish sensed complexness of the patient room sound environment as there are less noise beginnings in single-bed suites than multi-bed suites. In MedSurg-ICU, cardinal nurse station is a common-use workplace and at most times it is extremely popula ted by nurses for coaction, single work and telecommunication intents. Higher patient bend over rates ( new admittances and conveyances ) in MedSurg-ICU besides requires extra paper work to be done at the nurse station. In Neuro-ICU, nurses largely collaborate, work separately and telecommunicate at the de-central nurse Stationss. They visit the centralised nurse station for registering patient medical records, utilizing common resources such as copy-fax machine. Segregation of corridors used by household members and staff members can command riotous breaks by household members. On the other manus, household members can get down a insouciant conversation with staff members anytime while voyaging in the shared corridors. One of the chief noise beginnings in the health care scenes are conversations. Based on researchers` observation, the physical distance between the nurse Stationss or patient monitoring nucleuss can lend to the sensed frequence of the unprompted noise happenings. In this survey noise degree and happening rate of impulse sounds found to be critical for nurses` volume and irritation perceptual experience. In MedSurg-ICU, physical distance between two patient monitoring nucleuss ( from centre to centre ) was 48ft. In Neuro-ICU, same distance between two centralised nurse Stationss was 118ft. Distribution of noise beginnings based on layout constellation can escalate complexness of the perceived sound environment33. MedSurg-ICU race path layout design offers a more compact physical environment while Neuro-ICU bunch layout design provides more broad physical environment.5. Spectral content of the sound environment vs. subjective noise degreesStatistically important subjective noise degree differences between two unit nurse Stationss were non consistent with merely perceptible differences between RC values. However, more elaborate frequence analysis showed that clearly perceptible higher noise degrees occurred at 8kHz at MedSurg-ICU nurse station. Th is happening can be related with unprompted ( high noise degrees at high frequences ) nature of sound environment at the nurse Stationss. Statistically important subjective noise degree differences between two unit empty patient suites were consistent with clearly perceptible differences between RC values. This relationship can be explained by the steady nature of the sound environment in the empty patient suites. And this happening can besides foreground the dominancy of noise degrees at mid frequences in nurses` irritation and loudness perceptual experience in steady sound environments.VI. DecisionIn healthcare acoustics literature, it is widely accepted that noise degrees in critical attention scenes are really loud and raging. This survey agrees with this decision and reminds that features of different ICU sound environments can change drastically. Some of those differences are highlighted via elaborate comparative noise degree analysis between two units in this survey. Impulsiv eness ( high happening rate at high noise degrees ) degree of an ICU sound environment is suggested to be one of the chief indexs of sensed noise-induced nurse results and nurses` volume perceptual experience. At specific locations in the unit that have with steady sound environments, higher mean sound force per unit area degrees relates better to nurse irritation and volume degrees. Spectral content of the sound environment might besides be related with nurse irritation and loudness perceptual experience. Lower perceived noise-induced work public presentation can be expected in the units with higher address intervention degrees. Furthermore noise degrees at specific locations in the unit can be acoustically more debatable than the others where focussed intercessions can be necessary. For diagnosing of these possible conditions, conductivity of elaborate noise degree measurings at multiple different locations in the unit might be of import. During and after location specific noise d egree analysis, it might be good to oppugn whether peculiar acoustic metric used represents the general feature of the sound environment studied and observed. It might be critically of import for hospital decision makers to take enterprises for cut downing unprompted noise beginnings in ICUs such as reconsideration of dismay scenes that most times do n't match to exigency degree of the incidence, integrating of higher engineering for paging health professionals such as 3G-phones and avoiding overhead beepers. It might be critical for designers to see the recent technological progresss in HVAC systems to assist bettering occupant results. The sate-of-the-art HVAC system application in Neuro-ICU offers significantly less bothersome and quieter ( clearly perceptible ) sound environment in the patient suites compared to the HVAC noise generated by the older edifice system in MedSurg-ICU. In add-on to the application of technological progresss, strategic arrangement of the HVAC engine an d its insularity from the edifice construction can be critically of import to avoid possible feelable quivers and noises happening at really low frequences. Finally, in add-on to conventional acoustic intercessions ( i.e. absorbent surface stuff applications ) , some layout design considerations can besides be critical for the formation and consideration of the health care sound environments get downing from the early design stages.RecognitionsThis work has been partly supported by ASHRAE Graduate Student Grant-In-Aid. We appreciate GaTech Healthcare Acoustics squad members` partnership. We are thankful to Emory University and Dr. Owen Samuels for his advice. We are besides grateful to nurse pedagogues Ann Huntley and Mary Still, registered nurses Tim Rice and Anya Freeman and to all Neuro-ICU and MedSurg ICU nurses, patients and household members for their uninterrupted aid and forbearance during noise degree measurings in the units.