The Second Sex The Fight Against Women s Oppression

Simone de Beauvoir â€Å"The Second Sex’: The Fight against Women’s Oppression Simone Lucie Ernestine Marie Bertrand de Beauvoir simply referred to as Simone de Beauvoir was a French intellectual, writer, political activist, existentialist philosopher, social theorist and feminist born in 1908. Often subscribed to the schools of Existentialism, French Feminism and Western Marxism, she did not regard herself as a philosopher even though she is heralded for her significant influence of feminist theory and feminist. In her literal journal, Beauvoir wrote monographs and autobiography on philosophy, social issues and politics as well as biographies, essays and novels (Bauer, 2001). She is renowned for The Second Sex her 1949 treatise that offered†¦show more content†¦At the time if it’s writing and publication, there existed minimal philosophical works on women from a feminist perspective. With the exception of a few books the systematic oppressed treatment of women in modern age and historically were virtually unheard off. Striking on the basis of the profundity of its fundamental insights and research, The Second Sex subsist a foundational text in feminism, women studies and philosophy. The Second Sex’s main thesis revolves around the belief that a woman has always been held in a long-standing oppressive relationship to the man via her relegation to being the man’s â€Å"other.† In agreement with Sartrean and Hegelian Philosophy, Beauvoir depicts that the self needs otherness to define itself as a major subject. For this reason, the category of otherness is necessary for the establishment of self as a self (Beauvoir et al, 2010, pp.76-85). She however digresses through a feminist existential perspective by stating that the self-understanding movement via alterity should be reciprocal in nature, such that the self is objectified by its other just like the self objectifies it. This is the philosophical thought th at defines The Second Sex. Based on this understanding, The Second Sex aims at postulating the manner in which religious French social. Political, religions and literary traditions have developed a world in which conflicting and impossible femininity ideals propagate an ideology of women’s natural

Critical Care Sound Environments Health And Social Care Essay Free Essays

string(62) " cardiovascular harm particularly in hypertensive persons 12\." 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. We will write a custom essay sample on Critical Care Sound Environments Health And Social Care Essay or any similar topic only for you Order Now 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 studied, 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. Introduction The 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 concerns, 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 RESEARCH A. Overview of Hospital Acousticss 1. Results The 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 mismatch 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. You read "Critical Care Sound Environments Health And Social Care Essay" in category "Essay examples" 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, a nd decreased sense of personal achievement. This in bend can do feelings of ineffectualness, awkwardness, 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 prosodies There 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 compar ing 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 relation 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 have 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 feat ures 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 critical 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 environments Methods 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- whil e 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 Bruel 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 Al. 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. METHODOLOGY Puting The 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, distrusted 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. Measures 1. Sound Objective 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 ventilator 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 so und 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-report An 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 workplace, 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. Result A. Objective noise degrees 1. 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 † 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 respiratory 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 t he 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 corridors 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 nurse station and other locations were non ever perceptible based on differences between A-weighted Leq degrees. B. Subjective noise degrees 1. 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 corridors 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. Correlations 1. 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 content 1. Frequency distribution of noise degrees Overall, 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 500Hz, 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 re sidents but included in the design to supply natural visible radiation for some patient suites. 2. Room Criteria ( RC ) analysis In 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 clip F. Speech Interference Level In general, speech intervention degrees in MedSurg-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 degrees Background 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 acceptable 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. DISCUSSION One 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 degrees Overall nonsubjective sound environment of two units were significantly 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. S imilarly, elaborate nonsubjective noise degree measurings besides 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 degrees Location 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 environments 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 diffe rences 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 degrees 4. Features of infirmary sound environments and layout design applications Above 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 populated by nurs es 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 degrees Statistically 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. This 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. Decision In 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. Impulsiveness ( 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 degree 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 s ystems 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 and 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. Recognitions This 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. How to cite Critical Care Sound Environments Health And Social Care Essay, Essay examples

Macbeth and Oedipus Rex Comparison Essay free essay sample

Hero, as defined by Aristotle, is a man of noble reputation who is admired by society but has a tragic flaw, which leads to his downfall. Shakespeare and Sophocles were both inspired by the theme of Tragic Heroes and have used this theme in their plays Macbeth and Oedipus Rex, respectively. These plays teach us moral lessons and it is imperative to decide which character best fits the title of a Tragic Hero. Undoubtedly, Macbeth and Oedipus are both Tragic Heroes but in different ways. Hamartia is a tragic flaw, which leads to a reversal of good fortune. An analysis of the two characters’ hamartia, the sympathy they gain from the audience, the characters’ roles in their inevitable downfall, and the role of the supernatural will emphasize why Macbeth and Oedipus are both Tragic Heroes in different ways. Macbeth and Oedipus both had a hamartia. On the one hand, Macbeth’s hamartia was his ambition for power and gullibility in trusting the witches. This ambition made him commit heinous crimes and led him to trust the witches. He kept going back to the witches for more prophecies ever since the first two predictions made by them came true. He said to Lady Macbeth, â€Å"I will tomorrow—/ And betimes I will—to the weird sisters. / More shall they speak, for now I am bent to know,/ By the worst means, the worst. For mine own good,/ All causes shall give way. I am in blood/ Stepped in so far that, should I wade no more,/ Returning were as tedious as go oer. / Strange things I have in head, that will to hand,/ Which must be acted ere they may be scanned. /† (Macbeth, Act III, Scene 4, Lines 158-166) Macbeth’s flaw was that he became overconfident because of the witches’ predictions and made impulsive decisions based on these prophecies. He was gullible to believe that the witches were helping him; whereas the truth was that they were his real enemies. He also thought that he could control his fate based on the prophecies but he was mistaken because his downfall was inevitable. On the other hand, Oedipus’ hamartia was his lack of knowledge about his own identity and the curse that was given to him when he was a child. His determination to find out the truth was also a tragic flaw in him. Tiresias said to him, â€Å"I say that you have secretly have lived most foully with those who should be most dear nor do you see to what extent of evil you have come. (Oedipus, Lines 385-387) He had been cursed that he would kill his father and marry his mother. As a result, he was sent away by his birth parents in fear of this evil prophecy. Oedipus was raised by a shepherd and unknowingly killed his birth father and married his mother. He was completely unaware of the crime that he had committed and no amount of foresight or preemptive action could remedy Oedipus hamartia, unlike Macbeth. Macbeth was well aware of what he had done and his hamartia could have been remedied if he had been satisfied with what he had. He was greedy and had an increasing desire for more power. Macbeth became king by murdering King Duncan in cold blood, which was a horrific crime, whereas Oedipus becomes king by saving the city of Thebes from the Sphinx, which was a noble deed. Macbeth became king by choosing the wrong path of murder, but Oedipus gained kingship with the help of his unselfish deeds. Macbeth and Oedipus both had a tragic flaw, which eventually caused a reversal of their fortunes. Oedipus and Macbeth are Tragic Heroes, but in different ways. They both deserve sympathy from the audience. The audience can sympathize with Oedipus because his downfall was set before him by the Gods and he had no control over his fate. He had unknowingly killed his father and married his mother but the fact that he had to go into exile for the rest of his life makes the audience feel sympathy for him. He had committed a huge mistake and he had to suffer for the rest of his life, alone in banishment despite the fact that his crimes were unintentional. He says, â€Å"For if I had died then, I would not have brought so much pain to my friends or me! (Oedipus, Lines 1379-1381) Oedipus feels guilty for hurting his family and friends and wishes that he could go back and change it. He also punishes himself for his crimes by putting his eyes out and insisting that he deserves to go to exile. The audience sympathizes with Oedipus despite his wrongdoings. Similarly, Macbeth also has sympathy from the audience, but in a different manner. Macbeth initially had everything that a man could wish for: high status, popularity, and a loving wife. He was brainwashed by Lady Macbeth into killing King Duncan to attain the throne. Macbeth was hesitant at first, but once he killed Duncan, he was full of guilt. He had hallucinations and was constantly paranoid about anyone who may be a potential threat to his place on the throne. When Lady Macbeth died, he was briefly saddened by her death and realised that she should have lived longer, but he accepted the fate. Macbeth says, â€Å"She should have died hereafter. / There would have been a time for such a word. / Tomorrow, and tomorrow, and tomorrow,/ Creeps in this petty pace from day to day/ To the last syllable of recorded time,/ And all our yesterdays have lighted fools/ The way to dusty death. Out, out, brief candle! / Life’s but a walking shadow, a poor player/ That struts and frets his hour upon the stage/ And then is heard no more. It is a tale/ Told by an idiot, full of sound and fury,/ Signifying nothing. /† (Macbeth, Act V, Scene 5, Lines 19-28) Macbeth felt unable to grieve his wife’s death since he himself was dead on the inside and was void of emotions. There was no meaning left in his life and he felt that it had become worthless. At the end of the play, Macbeth chose to fight Macduff instead of running away like a coward. These actions of Macbeth make the audience feel that there was still some humanity left in him. He had not completely become a monster, and was still capable of human feelings despite the murders committed by him. The audience felt more sympathy and pity for Oedipus than Macbeth because Oedipus did not deserve such a harsh punishment for a crime that had been committed unintentionally, whereas Macbeth had complete knowledge of his wrongdoings but this did not stop him from committing several horrific crimes. Macbeth and Oedipus both initially had a high status, but they lost their status and this led to their unavoidable downfall. Macbeth was responsible for his own downfall because he allowed himself to be influenced by others. He ignored his conscience, which told him to not kill Duncan. Even before he killed Duncan, Macbeth knew what he was doing was wrong but he allowed Lady Macbeth and his ambition to cloud his judgement. Macbeth also trusted the witches and believed what they were saying was the truth and in his interest. Macbeth could have shrugged off the prophecies like Banquo did, but he chose to believe in the misinterpreted predictions, which ultimately led to his downfall. When the first two prophecies made by the witches came true, they initiated Macbeth’s desire to become king. Nobody told Macbeth to kill Duncan; but he was solely responsible for allowing Lady Macbeth to influence him. When the second prophecy came true, the first thought that came to Macbeth’s mind to attain the throne, was of murdering Duncan. He said, â€Å"I am Thane of Cawdor. / If good, why do I yield to that suggestion / Whose horrid image doth unfix my hair† (Macbeth, Act I, Scene 3, Lines 145-147). On the other hand, Oedipus also caused his downfall but in a different way. He was determined to discover the true identity of his birth parents and this determination led to his downfall. He, like Macbeth, thought that he could control his fate. He said, â€Å"For not on behalf of more distant friends, but as if from myself I shall dispel the stain. † (Oedipus, Lines 148-149) Oedipus believed that he could find Laius’ murderer but he did not know that he was the murderer himself. This determination to discover the truth led Oedipus towards his downfall. Even when he was told that he did not need to know the truth he coaxed Tiresias into telling him the truth. Oedipus took the first step towards his downfall by thinking that he could escape his fate. It is ironical that Oedipus made unknowing decisions, which took him closer to his fate of killing his father, marrying his mother, and going into exile as a â€Å"blind beggar†. The harder he tried to flee, the closer he moved towards his fate. Oedipus unknowingly killed his father and married his mother, but when he learned of this horrific crime, he put his eyes out and is was sent to exile as a â€Å"blind beggar†, thus proving that fate is inescapable. Macbeth and Oedipus both caused their own downfall. The difference between the two is that Macbeth’s greed made him commit crimes, whereas Oedipus committed the crimes unintentionally. The supernatural had a great impact on Macbeth and Oedipus’ downfall and was a vital part of both the plots. In Macbeth, the supernatural appeared to the audience in many varied forms – Macbeth hallucinated a dagger and Banquo’s ghost, which gave Macbeth’s character intensity. When Macbeth went to the witches to seek more advice prophetic apparitions made appearances, which enhanced the supernatural effect. The three witches were the strongest supernatural force in the play. They told Macbeth his future but did not show him the path towards his future. They gave him predictions and then left it to him to interpret them. There was a supernatural theme, which was present throughout the play. The witches say, â€Å"Fair is foul, and foul is fair† (Macbeth, Act I, Scene 1, Line 11) which means that what Macbeth thought was good turned out to be bad, and what he thought was bad turned out to be good. Nothing was what it seemed like because the witches were irredeemably evil and were Macbeth’s enemies, but Macbeth trusted them and thought that they were his allies. Macbeth’s irrevocable trust on the witches and misinterpretation of their predictions led him towards his downfall. The witches used Macbeth’s trust in them as a weapon against him by playing on an important aspect of his character, which was his ambition. Apart from Macbeth’s greed and gullibility, the supernatural force in the play, the witches, was the cause of his downfall. Similarly, a supernatural force led Oedipus to his downfall as well. Like Macbeth, Oedipus also received a prediction, but from a Delphic Oracle. Oedipus wanted to know the true identity of his birth parents from the Oracle. He did not get a straight answer to his question but instead the Oracle prophesized that Oedipus would kill his father and marry his mother. Oedipus said, â€Å"But telling me other awful things that I must sleep with my mother, and that I would bring to light a brood unbearable for men to see, and that I must be the slayer of the father who sired me. I heard and fled, henceforth to share with Corinth only the stars, where I would never see completed the disgrace of those evil oracles of mine. (Oedipus, Lines 814-821) Oedipus believed in prophecies and so he fled in an attempt to control his fate and also to prevent him from committing ghastly crimes. The Oracle used this belief and predetermined Oedipus’ fate. Oedipus also visited Apollo’s shrine where he learned that the murderer of King Laius must be identified and punished. He decided to find the murderer, not knowing that he was the mu rderer himself, and also determined a punishment of execution or exile. Oedipus therefore foredoomed his tragedy when he discovered that he was the killer of his birth father and husband of his birth mother. The Gods had predetermined Oedipus’ fate and no matter what he did, he was unable to escape it. The supernatural force played an important role in Oedipus’ downfall because it was the predictions that drew him closer to his fate and helped him recognize his role in his downfall. Oedipus and Macbeth both initially had a lot of power and popularity but were unable to keep it for a very long time. They both committed ghastly crimes but Macbeth did them intentionally whereas Oedipus did not. Oedipus and Macbeth both had tragic flaws, which led to a reversal of fortune but their flaws were different from each other as Oedipus had determination to eek the truth while Macbeth was consumed with greed. They both tried to control their fate. Macbeth did so to attain power whereas Oedipus tried to control his fate in order to save his family from being hurt by the curse. These two Tragic Heroes teach us the lesson that irresponsible use of power ultimately causes loss of authority and inevitable downfall. Therefore, it is evident that Shakespeare’s Macbeth and Sophocles’ Oedipus both fit the criteria of a Tragic Hero but in different ways.