Exploring a cardio-thoracic hospital ward soundscape in relation to restoration

Hospitals can provide stressful experiences for both patients and medical staff. A well-designed hospital soundscape should avoid adding to negative emotional states (e.g. stress), limit any detrimental cognitive effects (e.g. attentional fatigue), and enable restoration. Experiences of the cardio-thoracic ward soundscape, in a UK public University hospital, were explored via semi-structured interviews with 11 patients and 16 nurses. Thematic coding analysis resulted in 11 key themes including notions of restoration and emotional responses. The themes were used to develop a conceptual model to describe the processes involved in the perception and evaluation of the soundscape. The language used by patients and nurses indicated the emotional response to the soundscape was at times stressful and at others potentially restorative. Coping methods of accepting and habituating to individual sounds were noted. The impact of the patients' and nurses' ability to maintain these coping strategies are discussed in relation to restoration and the temporal variation of the soundscape. A period of 'quiet time' was in operation at the hospital and the importance of this was noted through various responses relating to emotion and restoration. The results suggest the soundscape has potentially, a beneficial role in facilitating restoration thus helping patients' recovery and medical staff's ability to remain productive. This research supports the need to study hospital soundscapes further so that design implications can be considered for the production of a more restorative environment, possibly through the masking/removal of unwanted sounds and optimising positive sounds

A Current Bibliography on the History of Canadian Population and Historical Demography in Canada. 1989

This is a continuation of the bibliography published by the journal for its readers since 1978.** It is compiled from the bibliographies published in Acadiensis, BC Studies, Canadian Historical Review, Canadian Ethnic Studies, the Canadian Slavonie Papers, the Revue d'histoire de l'Amérique française, the Urban History Review, and with the help of the Anthropological Index, the Population Index, the International Bibliography of Historical Demography and the Annotated Bibliography of Canadian Demography. In addition, over seventy periodicals, a list of which may be obtained from us, were consulted. As previously, only books and articles in hand have been enumerated. Please bring to our attention those we may have overlooked for inclusion in the next bibliography

Genomic and non-genomic effects of mineralocorticoid receptors and glucocorticoid receptors and their roles of pain modulation

Corticosteroids, including mineralocorticoids and glucocorticoids, are best known for their effective relief of inflammation and pain through activation of the intracellular mineralocorticoid (MR) and glucocorticoid receptors (GR) that changes gene transcription in a classical genomic pathway. However in addition to these known genomic effects, corticosteroids have been recently shown to also elicit rapid non-genomic effects in the central nervous system. The exact localization of MR and GR in a specific subset of sensory neurons and/or glia cells within the spinal cord and the peripheral nervous system as well as their potential in the modulation of sensory stimuli such as pain still remains elusive. In naïve rats as well as rats with FCA-induced hind-paw inflammation, I investigated the expression of MR and GR and their anatomical location in peripheral neurons and glia cells as well as their alterations under painful inflammatory conditions. Moreover, I examined in behavior experiments changes in nociceptive mechanical sensitivity following the local and systemic application of MR or GR agonists with and without respective antagonists. Similar to kidney tissue, MR and GR mRNA and specific receptor proteins were identified in dorsal root ganglia. Double immunofluorescence confocal microscopy revealed that MR are predominantly expressed in unmyelinated peptidergic nociceptive neurons, whereas GR are prominent in both peptidergic and non-peptidergic nociceptive neurons. MR and GR expression in glia cells is not very prominent and seems to play a minor role. Local application (intraplantar or intrathecal) of the MR selective agonist aldosterone acutely increased, whereas MR selective antagonists reduced nociceptive behavior. Systemic injection of the GR agonist dexamethasone and the MR antagonist canreonate-K but less their combination dose-dependently attenuated nociceptive behavior during inflammatory pain. Overall, these studies provided firm evidence for the existence of MR and GR in specific nociceptive neurons and for hitherto unknown rapid non-genomic effects of MR and GR agonists/antagonists to modulate nociception.Corticosteroide, einschließlich Mineralocorticoide und Glucocorticoide, sind am besten bekannt für ihre wirksame Linderung von Entzündung und Schmerz durch Aktivierung der intrazellulären Mineralocorticoid- (MR) und Glucocorticoid-Rezeptoren (GR), indem sie die Gentranskription im Sinne des klassischen genomischen Signalwegs verändern. Zusätzlich zu diesen bekannten genomischen Wirkungen wurde kürzlich gezeigt, dass Corticosteroide auch schnelle nicht-genomische Wirkungen im zentralen Nervensystem hervorrufen können. Bisher ungeklärt ist die genaue Lokalisation von MR und GR in spezifischen Untergruppen sensorischer Neurone und / oder Gliazellen innerhalb des Rückenmarks und peripheren Nervensystems sowie deren Potential bei der Modulation von Sinnesreizen, wie zum Beispiel Schmerz. In naiven Ratten sowie Ratten mit FCA-induzierter Hinterpfotenentzündung untersuchte ich die Expression von MR- und GR und deren anatomische Lokalisation in peripheren Neuronen und Gliazellen sowie deren Veränderungen unter schmerzhaften Entzündungsbedingungen. Darüber hinaus untersuchte ich in Verhaltensexperimenten Veränderungen der nozizeptiven mechanischen Sensitivität nach lokaler und systemischer Applikation von MR- oder GR-Agonisten mit und ohne respektive Antagonisten. Ähnlich wie im Nierengewebe konnten MR- und GR-mRNA und spezifische Rezeptorproteine in den Spinalganglien identifiziert werden. Die Doppelimmunfluoreszenz-Konfokalmikroskopie zeigte, dass MR vorwiegend in nicht-myelinisiertenpeptidergennozizeptiven Neuronen exprimiert werden, während GR sowohl in peptidergen als auch in nicht-peptidergennozizeptiven Neuronen vorherrschend sind. MR- und GR-Expression in Glia-Zellen war nicht sehr prominent und schien eine untergeordnete Rolle zu spielen. Die lokale Applikation (intraplantar oder intrathekal) des MR-selektiven Agonisten Aldosteron erhöhte, wohingegen die des MR-selektive Antagonisten reduzierte die nozizeptive mechanische Sensitivität. Systemische Applikation des GR-Agonisten Dexamethason und des MR-Antagonisten Canreonate-K, jedoch weniger ihre Kombination bewirkte eine dosisabhängige Reduktion des nozizeptiven Verhalten bei entzündlichen Schmerzen. Insgesamt lieferten diese Studien einen Beweis für die Existenz von MR und GR in spezifischen nozizeptiven Neuronen und für bisher unbekannte, schnell einsetzende nicht-genomische Wirkungen von MR- und GR-Agonisten / Antagonisten zur Modulation nozizeptiver Sinneswahrnehmungen