Cross-sectional Analysis of Sound Levels in the Neonatal Intensive Care Unit (NICU) at Thomas Jefferson University Hospital

Introduction . Infants in the NICU are considered at greater risk of developmental delay. It is now known that excessively loud noise can have a negative impact on parameters such as blood pressure, breathing, heart beat and oxygen saturation. Previous research has concluded that the optimal decibel (dB) level for proper growth of neonate hair cells rests around 45dB. Consequently, the American Academy of Pediatrics recommends that noise levels in the NICU be maintained to a maximum of 45dBA. However, little research has focused on designing new noise-altering products and their impact on neonatal outcomes. Methods. This was a cross sectional study. The NICU at Thomas Jefferson University Hospital was observed for room arrangements and general workflow. Additionally, decibel levels around empty neonatal incubators were measured. A decibel analyzer (REED Instruments SD-4023, Wilmington, NC) was used to record sound levels, both inside and outside of isolettes during various routine activities, including patient rounds, provider-parent conversations and vital monitoring alarms. Results. 30 discrete data points were surveyed, in addition to a 24-hour continuous decibel recording. Across all discrete data points, decibel levels had a mean of 65.6dB (SD ± 10.3). Ambient noise alone in a patient room was measured at 50dB. Noise levels in an open and closed isolette were measured at 58 and 57dB, respectively. Isolette side door opening and closing had a mean of 80.2dB (SD ± 7.60). With medical devices active in the patient room, noise levels had a mean of 62.7dB (SD ± 7.74). Conclusions. All data points were above the recommended safe noise level of 45dB. This data supports our development of a noise reduction product for use within neonatal isolettes. Our design will incorporate sterilizable, sound-absorbent materials and diffusion technologies to decrease ambient noise within neonatal incubators

An Investigation into Gender Bias in the Employment Institutions

This paper describes part of the results of a research project undertaken at the Employment Institutions. The purpose of this research was to consider whether, and if so, in what way, the Employment Court and the Employment Tribunal contribute to the general position of greater disadvantage experienced by women workers since the introduction of the Employment Contracts Act. This paper examines reported decisions of the Court and Tribunal over the 1991-1994 period, focusing on personal grievances, and concludes that while the employment institutions' decisions themselves do not disclose a pattern of gender bias, there is evidence of gender bias in the awards 1nade to parties, particularly in awards compensating for humiliation, loss of dignity and injury to the feelings of the employee

A "Mean Hard Place"? Law Students Tell it as it is

Empirical research carried out in the US in the last 10-15 years reveals that law students are generally dissatisfied with their experiences there. The negative effects of legal education are particularly marked for female students. This study, carried out at Victoria University of Wellington in late 2004 seeks to replicate earlier United States studies and queries whether the influx of female students into law school in the past ten years has effected any change in how law school is experienced. It asks: how comfortable are students with lecturer interactions inside and outside the classroom? with student interactions? how attached are they to their law school? why did they come to law school and how do they feel about their performance while there

Book Review: The Constitution of Independence

This article is a book review of Peter C Oliver The Constitution of Independence: The Development of Constitutional Theory in Australia, Canada, and New Zealand (Oxford University Press, Oxford, 2005) (367 + xx pages). The book is a contribution to the area of domestic constitutional law of the Commonwealth. Oliver addresses the question: are the former colonies of Britain ever truly independent, or is that independence illusory? He also asks how such colonies seek to understand and explain their constitutional history. Morris argues that the book had a great deal of potential but has been left unrealised. As a legal historiography, the book does not always satisfactorily explain how people involved in creating that legal history (or in analysing it since) understand it. As an exercise in constitutional theory, the book merely suggests that there is nothing much to choose between theories as a matter of logic. The book also suffers from very dense prose and a number of distracting metaphors for the process of constitutional independence. Morris ultimately concludes that the book fails to provide useful insight into New Zealand's constitutional theory

Malaria: Sub-Saharan Africa

Sub-Saharan Africa is the large area situated south of the Saharan desert. It is considered one of the poorest regions in the world; the territory faces many challenges in respect to public health. One of the most important issues that sub-Saharan Africa faces is malaria. It is spread through the female Anopheles mosquito. Environmental factors of sub-Saharan Africa heavily influence the rates of incidence in the region due to high populations of mosquitoes. Social determinants of health affect risk in the sub-Saharan populations. Little access to healthcare, built environment, and education all impact incidence of malaria in the region. Children under the age of 5, pregnant women, and travelers are at the highest risk for contracting malaria. Interventions have already been implemented in the region; they include indoor residual spraying and bed nets. Strengthening healthcare systems and expanding vaccination research both are possible interventions for the future of malaria in sub-Saharan Africa

The Governor-General, the reserve powers, Parliament and MMP: A new era

This article considers the reserve powers of the Governor-General to refuse a request for a dissolution of Parliament and to appoint a Prime Minister. Generally, these powers have not been the subject of much discussion or even considered to be of any great importance in constitutional debate. Yet the move to a mixed member proportional ("MMP") electoral system, endorsed by New Zealanders in a binding referendum in 1993, disturbs this previously settled consensus. MMP may mean that the reserve powers are called upon more often to solve constitutional dilemmas. Thus this article seeks to address the issues that arise from the new context for the operation of the reserve powers and further, to suggest some new conventions which may go some way towards the resolution of those issues

"Remember the Ladies": a Feminist Perspective on Bills of Rights

Women have been made legislators comparatively recently in the history of western democracies, but they have sought to influence the content of laws for centuries. The author examines the UK Human Rights Act 1998 ('UKHRA') and New Zealand Bill of Rights Act 1990 ('NZBORA') from a feminist perspective. The article begins by exploring the nature of rights generally, concluding that both NZBORA and UKHRA only enshrine "first generation rights" which represent only the male perspective of human rights discourse. While these legislated human rights have been used to enforce women's interests in court, the same rights are also used to restrict women's interests (for example, in the criminal justice process). It is difficult to construct a case for women within any Bill of Rights framework when the rights they rely on are outside said framework. The author therefore concludes that the Courts have failed to live up to the promise of achieving justice for wome