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Noise Pollution: Do We Need a Solution? An Analysis of Noise in a Cardiac Care Unit
- Kevin M. Ryan, Matthew Gagnon, Tyler Hanna, Brad Mello, Mustapha Fofana, Gregory Ciottone, Michael Molloy
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- Journal:
- Prehospital and Disaster Medicine / Volume 31 / Issue 4 / August 2016
- Published online by Cambridge University Press:
- 23 May 2016, pp. 432-435
- Print publication:
- August 2016
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- Article
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Introduction
Hospitals are meant to be places for respite and healing; however, technological advances and reliance on monitoring alarms has led to the environment becoming increasingly noisy. The coronary care unit (CCU), like the emergency department, provides care to ill patients while being vulnerable to noise pollution. The World Health Organization (WHO; Geneva, Switzerland) recommends that for optimum rest and healing, sound levels should average approximately 30 decibels (dB) with maximum readings less than 40 dB.
ProblemThe purpose of this study was to measure and analyze sound levels in three different locations in the CCU, and to review alarm reports in relation to sound levels.
MethodsOver a one-month period, sound recorders (Extech SDL600; Extech Instruments; Nashua, New Hampshire USA) were placed in three separate locations in the CCU at the West Roxbury Veterans’ Administration (VA) Hospital (Roxbury, Massachusetts USA). Sound samples were recorded once per second, stored in Comma Separated Values format for Excel (Microsoft Corporation; Redmond, Washington USA), and then exported to Microsoft Excel. Averages were determined, plotted per hour, and alarm histories were reviewed to determine alarm noise effect on total noise for each location, as well as common alarm occurrences.
ResultsPatient Room 1 consistently had the lowest average recordings, though all averages were >40 dB, despite decreases between 10:00 pm and 7:00 am. During daytime hours, recordings maintained levels >50 dB. Overnight noise remained above recommended levels 55.25% of the period in Patient Room 1 and 99.61% of the same time period in Patient Room 7. The nurses’ station remained the loudest location of all three. Alarms per hour ranged from 20-26 during the day. Alarms per day averaged: Patient Room 1-57.17, Patient Room 7-122.03, and the nurses’ station - 562.26. Oxygen saturation alarms accounted for 33.59% of activity, and heart-related (including ST segment and pacemaker) accounted for 49.24% of alarms.
ConclusionThe CCU cares for ill patients requiring constant monitoring. Despite advances in technology, measured noise levels for the hospital studied exceeded WHO standards of 40 dB and peaks of 45 dB, even during night hours when patients require rest. Further work is required to reduce noise levels and examine effects on patient satisfaction, clinical outcomes, and length of stay.
,Ryan KM ,Gagnon M ,Hanna T ,Mello B ,Fofana M ,Ciottone G .Molloy M Noise Pollution: Do We Need a Solution? An Analysis of Noise in a Cardiac Care Unit . Prehosp Disaster Med.2016 ;31 (4 ):432 –435 .
11 - Viral delivery of shRNA
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- By Ying Mao, BD Biosciences Clontech, Chris Mello, BD Biosciences Clontech, Laurence Lamarcq, BD Biosciences Clontech, Brad Scherer, BD Biosciences Clontech, Thomas Quinn, BD Biosciences Clontech, Patty Wong, BD Biosciences Clontech, Andrew Farmer, BD Biosciences Clontech
- Edited by Krishnarao Appasani, GeneExpression Systems, Inc., Massachusetts
- Foreword by Andrew Fire, Stanford University, California, Marshall Nirenberg
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- Book:
- RNA Interference Technology
- Published online:
- 31 July 2009
- Print publication:
- 17 January 2005, pp 161-173
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Summary
Introduction
The completion of the human genome has made available the sequences of thousands of genes (Baltimore, 2001), allowing researchers to switch focus from identifying genes to understanding their function. In broad terms, gene function studies can be classified into two categories: those where the gene of interest is introduced into a system in which it is not expressed, and those in which the gene is disrupted or removed. While over-expression studies are fairly straightforward, methods for gene inactivation have been hampered in higher eukaryotes by the difficulty in manipulating their genetic material. Thus, although it is possible to generate mice lacking genes of interest by homologous recombination (Capecchi, 1989; van der Weyden et al., 2002), such studies remain technically challenging and expensive. Moreover, in some cases, deletion of a gene may be lethal, preventing its analysis (e.g., Lui et al., 1996). Alternatively, the phenotype produced may differ from that expected in humans (Harlow, 1992; Lee et al., 1992). A simple method for effective genetic inactivation in somatic cells in vitro is greatly needed, but has remained elusive (Sedivy and Dutriaux, 1999). Not surprisingly, recent years have seen considerable interest in a novel method for inactivating gene function in somatic cells that exploits the phenomenon of RNA interference (RNAi), first described by Fire et al. (1998). In their seminal study, they showed that double-stranded (ds)RNA homologous to a gene of interest could inhibit its expression. The dsRNA is digested into 21–23 nucleotide small interfering RNAs (siRNAs).