Noise in Preschools and its Psychological and Cardiovascular Effect on Preschool Teachers.

Purpose: Noise exposure in preschools is cited as one of the main stresses by preschool teachers in surveys worldwide. Hearing-related symptoms as well as physiological stress reactions are often mentioned in this context. Therefore, the aim of the study was to investigate whether the noise has an impact on the cardiovascular activity of the preschool teachers. Methods: The study took place in nine private preschools in Vienna. In the classrooms of 23 preschool teachers stationary noise recordings were conducted and the participants were equipped with 24-hour electrocardiograms (ECGs). Questionnaires on noise-related stress, well-being, stress perception, burnout risk, noise annoyance, and noise sensitivity were provided. Data were described descriptively and correlations and one-way analyses of variance (ANOVAs) with repeated measures were performed. Results: The average sound pressure level in the classrooms during the first four hours was LAeq 74.7 dB(A) (standard deviation [SD] = 1.74). A significant correlation between heart rate and sound pressure level (LAeq,4 h) was found, r = 0.40, P = 0.04 (one-tailed). Noise sensitivity and noise annoyance showed no effect. With increasing sound level classes [≤65 dB(A), 66-75 dB(A), 76-85 dB(A)], the heart rate increased significantly, and the heart rate variability decreased significantly. It was also found that tolerating noise becomes more difficult with increasing length of employment and increasing age. Conclusion: The noise level in classrooms showed an impact on the cardiovascular activity of preschool teachers, which can be considered as an indicator of stress. Measures to reduce noise in preschools are recommended.

Acoustic noise alters selective attention processes as indicated by direct current (DC) brain potential changes.

Acoustic environmental noise, even of low to moderate intensity, is known to adversely affect information processing in animals and humans via attention mechanisms. In particular, facilitation and inhibition of information processing are basic functions of selective attention. Such mechanisms can be investigated by analyzing brain potentials under conditions of externally directed attention (intake of environmental information) versus internally directed attention (rejection of environmental stimuli and focusing on memory/planning processes). This study investigated brain direct current (DC) potential shifts-which are discussed to represent different states of cortical activation-of tasks that require intake and rejection of environmental information under noise. It was hypothesized that without background noise rejection tasks would show more positive DC potential changes compared to intake tasks and that under noise both kinds of tasks would show positive DC shifts as an expression of cortical inhibition caused by noise. DC potential shifts during intake and rejection tasks were analyzed at 16 standard locations in 45 persons during irrelevant speech or white noise vs. control condition. Without noise, rejection tasks were associated with more positive DC potential changes compared to intake tasks. During background noise, however, this difference disappeared and both kinds of tasks led to positive DC shifts. Results suggest-besides some limitations-that noise modulates selective attention mechanisms by switching to an environmental information processing and noise rejection mode, which could represent a suggested "attention shift". Implications for fMRI studies as well as for public health in learning and performance environments including susceptible persons are discussed.

Treatment of fear of flying: behavioral, subjective, and cardiovascular effects.

BACKGROUND: Nonaviator fear of flying is a common problem usually managed with behaviorally oriented treatment. The unknown time courses of aspects of anxiety and of physiological response were investigated during a 3-d treatment including flights. METHODS: Ratings, heart rate (HR), and heart rate variability (HRV; pNN10, pNN50) of 15 Moderate-Anxious and 9 High-Anxious subjects at critical epochs of treatment and on 2 actual flights, on which 9 Controls participated, were compared. RESULTS: All subjects took the flights and displayed a remarkably reduced fear when comparing pre- vs. post-treatment ratings. Repeated ratings showed an increase in relaxation and drops in general somatic and cognitive aspects of anxiety during flights. However, cognitive aspects in High-Anxious did not drop to the level of Controls. Level of anxiety was related to cardiovascular activity almost always during treatment and flights, in particular during takeoffs (average maximum HR of 137 bpm in High-Anxious compared to 118 bpm in Moderate-Anxious and 98 bpm in Controls in the first flight). Moderate-Anxious showed no obvious relationship of cardiovascular response to critical flight epochs, but had the lowest HRV on flights. DISCUSSION: Results indicate that anxiety in Moderate-Anxious is related to flight, but not to single critical epochs of flying, contrary to High-Anxious, for which higher ratings on cognitive aspects of anxiety associated with more physiological load at critical epochs were observed. However, HR and ratings showed a remarkable drop in both treatment groups, in particular in perceived physiological symptoms, indicating that the treatment facilitates coping of fear of flying.

Effects of low intensity noise from aircraft or from neighbourhood on cognitive learning and electrophysiological stress responses.

The effects of low intensity noise on cognitive learning and autonomous physiological processes are of high practical relevance but are rarely addressed in empirical investigations. This study investigated the impact of neighbourhood noise (of 45 dB[A], n=20) and of noise coming from passing aircraft (of 48 dB[A] peak amplitude presented once per minute; n=19) during computer based learning of different texts (with three types of text structure, i.e. linear text, hierarchic hypertext, and network hypertext) in relation to a control group (35 dB[A], n=20). Using a between subjects design, reproduction scores, heart rate, and spontaneous skin conductance fluctuations were compared. Results showed impairments of reproduction in both noise conditions. Additionally, whereas in the control group and the neighbourhood noise group scores were better for network hypertext structure than for hierarchic hypertext, no effect of text structure on reproduction appeared in the aircraft noise group. Compared to the control group, for most of the learning period the number of spontaneous skin conductance fluctuations was higher for the aircraft noise group. For the neighbourhood noise group, fluctuations were higher during pre- and post task periods when noise stimulation was still present. Additionally, during the last 5 min of the 15 min learning period, an increased heart rate was found in the aircraft noise group. Data indicate remarkable cognitive and physiological effects of low intensity background noise. Some aspects of reproduction were impaired in the two noise groups. Cognitive learning, as indicated by reproduction scores, was changed structurally in the aircraft noise group and was accompanied by higher sympathetic activity. An additional cardiovascular load appeared for aircraft noise when combined with time pressure as indicated by heart rate for the announced last 5 min of the learning period during aircraft noise with a peak SPL of even 48 dB(A). Attentional mechanisms (attentional control) like being threatened by passing aircraft approaching the airport, higher demands of selective filtering, and difficulties in changing cognitive strategies during noise are discussed as underlying mechanisms.

New head exposure system for use in human provocation studies with EEG recording during GSM900- and UMTS-like exposure.

A new head exposure system for double blinded human provocation studies, which requires EEG recording during exposure with GSM900- and UMTS-like signals has been developed and dosimetrically evaluated. The system uses planar patch antennas fixed at 65 mm distance from the subject's head by a special headset, which provides minimum impairment of the test subjects and ensures an almost constant position of the antennas with respect to the head, even in case of head movements. Compared to exposure concepts operating small antennas in close proximity to the head, the concept of planar antennas at a certain distance from the head produces a much more homogeneous SAR distribution in the temporal and parietal lobe of the brain. At the same time the resulting uncertainty of exposure due to variations in head size, variations of the dielectric properties of tissues and unavoidable small changes of the antenna's position with respect to the head, is reduced to the order of approximately 3 dB, which is a significant improvement to comparable head exposure systems reported in literature in the past. To avoid electromagnetic interference on the EEG recording caused by the incident RF-field an appropriate double-shielded filter circuit has been developed. Furthermore, the effect of the presence of the sintered Ag/AgCl EEG electrodes and electrode wires on the SAR distribution inside the head has been investigated and was found to be minimal if the electrode wires are arranged orthogonal to the incident electric field vector. EEG electrode arrangement parallel to the incident field vector, however, might cause drastic changes in the SAR distribution inside the head.

Impact of background noise on reaction time and brain DC potential changes of VDT-based spatial attention.

Background noise is often discussed in terms of mental costs. In this study the effect of background noise on brain activity as reflected by the direct coupled (DC) potential was investigated by a within design in ten participants. During two successive blocks of 7 min each, participants performed 156 trials of a visual display terminal (VDT)-based visual-spatial attention task without noise and two blocks with a mixture of the environmental noises of barking dogs, traffic noise and irrelevant speech of 60 dBA. Brain DC potentials were recorded along the midline and analysed for change by time on task. For noise conditions, reaction time was prolonged and the DC-potential shifted towards positivity, contrary to control condition, independent of block and location. Results suggest reduced cortical resources by widespread inhibitory activation through background noise. It can be concluded that even low intensity background noise is associated with energy consumption and with impaired performance in spatial attention.

Voluntary whole-blood donors, and compensated platelet donors and plasma donors: motivation to donate, altruism and aggression.

BACKGROUND AND OBJECTIVES: To establish if voluntary whole-blood donors and compensated platelet donors and plasma donors may differ in their motivation to donate, altruism, aggression and autoaggression. MATERIAL AND METHODS: Whole-blood (n=51), platelet (n=52) and plasma donors (n=48) completed a battery of validated questionnaires while waiting to donate. Bivariate and multivariate analyses of variance and t-tests were performed to detect differences between groups as noted. RESULTS: Altruism (mean=40.2) was slightly higher in whole-blood donors than in platelet (mean=38.3) and plasma donors (mean=39.1) (p=0.07). Blood donors (mean=2.8) scored lower in the spontaneous aggression measure than platelet (mean=4.1) and plasma donors (mean=4.4) (p=0.01). Plasma donors (mean=4.9) had higher auto-aggression than whole-blood donors and platelet donors (mean for both groups=3.4) (p=0.01). Differences between the three groups were mediated by sociodemographic variables (MANCOVA). Whole-blood donors donated to help others, platelet and plasma donors mostly to receive the compensation. However, those platelet and plasma donors, who would continue to donate without compensation were similar in altruism and aggression to whole-blood donors. CONCLUSION: While most platelet donors and plasma donors were motivated by the compensation, those who stated that they would continue to donate without compensation had altruism and aggression scores similar to voluntary whole-blood donors.

The functional assessment of cancer-vulvar: reliability and validity.

OBJECTIVES: To assess the reliability and validity of the Functional Assessment of Cancer Therapy-Vulvar (FACT-V). METHODS: Seventy-seven patients treated between January 1996 and January 2001 for cancer of the vulva completed the FACT-V, the Eastern Cooperative Oncology Group Performance Status Rating (ECOG-PSR) and the Hospital Anxiety and Depression Scale (HADS) once, 20 consecutive patients treated between February 2001 and October 2001 completed the questionnaires twice, once before surgery and at 2 months follow-up. The FACT-V scores were compared by patients' performance status, FIGO stage, recurrence, and age, and correlated to the HADS scores. Changes in the FACT-V from baseline to 2 months follow-up were evaluated to establish FACT-V's responsiveness to change. RESULTS: The FACT-V's internal consistency was adequate (Chronbach's alpha range, 0.75 to 0.92). Patients with lower performance status, higher FIGO-stage or recurrent disease received lower FACT-V scores, indicating discriminant validity. The correlation between the FACT-V and the HADS were in the expected direction, indicating convergent and divergent validity. From pre- to post-surgery, scores in nine out of fifteen items of the vulvar cancer-specific subscale improved, while those of five items declined, indicating sensitivity of the vulvar cancer specific items to changes in patients' well-being. CONCLUSIONS: The newly developed FACT-V provides a reliable and valid assessment of the quality of life of women with vulvar cancer. It can be used as a short measure of quality of life within research studies, and to facilitate communication about quality of life issues in clinical practice.

Effects of transdermally administered nicotine on aspects of attention, task load, and mood in women and men.

This double-blind placebo-controlled study was conducted to determine nicotine effects on diverse types of attentional performance, task load, and mood considering sex effects as suggested by animal studies. Twelve smokers, 12 deprived smokers and 12 nonsmokers (6 females, 6 males in each group) were investigated. Participants were treated either by 5 mg/16 h nicotine patches (Nicorette) or placebo. Effects of treatment were examined by a computerized attention-test battery; mood was assessed by the Berliner-Alltagssprachliches-Stimmungs-Inventar and task load by the NASA Task Load Index (NASA-TLX). Results showed that nicotine significantly increased the number of hits and decreased reaction time (RT) in the vigilance task. In the selective attention task combined with irrelevant speech as background noise, nicotine enhanced rate of hits. Although it was indicated that nicotine leads to a generally higher accuracy in attention tasks, response time of visual search was prolonged, contradicting a universal facilitation by nicotine. Participants experienced mental demand and temporal demand lower and rated alertness higher when in the nicotine condition. These effects were independent of smoking status, indicating "true" nicotine effects. Females took significant advantage of nicotine in the vigilance task, reaching the performance level of males, accompanied by a higher rated alertness. Results indicate task- and sex-dependent nicotine effects.

Impaired quality of life in patients commencing radiotherapy for cancer.

BACKGROUND: This study tested a three-item questionnaire to measure global quality of life (QOL) and pain in patients commencing radiotherapy, based on items from the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 instrument. PATIENTS AND METHODS: In a pretest, the EORTC QLQ-C30 and the three-item short questionnaire were administered to 100 patients, yielding similar global QOL and pain scores. After the pretest, the three-item questionnaire was administered to 1,837 patients prior to first radiotherapy treatment. RESULTS: 254 (13.8%) patients with impaired QOL were identified. These patients had a mean global QOL score of 32.6 compared to 72.4 (p < 0.001) found in patients with satisfactory QOL. Patients with impaired QOL were also more likely < 60 years and treated for lung, gastrointestinal or head and neck cancer or advanced, metastatic cancer. CONCLUSION: This brief questionnaire addresses important aspects of QOL, is feasible to use in a clinical setting and therefore represents a potentially useful tool for detecting those patients who may benefit from further evaluation and/or psychosocial support.

Stress response caused by system response time when searching for information on the Internet.

System response time (SRT) is suspected to be a stress-inducing factor when searching for information during human-computer interactions. In this study 26 volunteers, grouped into skilled and unskilled Internet users, completed three tasks of searching for information on the Internet, whereupon they rated their strain. Heart rate, nonspecific skin conductance responses, and skin conductance level after SRTs lasting 2, 10, and 22 s were analyzed. Results showed physiological stress responses of higher heart rates and enhanced electrodermal activity related to SRT duration, independent of expertise. For persons experiencing high strain, a higher overall heart rate and a heart rate of 114 beats per minute were observed for the 22-s condition. As no significant effect of expertise on stress response was found, this indicates that no long-term habituation took place. To avoid stress, short SRTs and/or effective coping mechanisms are recommended. The potential application of this research is the suggestion of using a fast Internet connection to reduce the stress response.

Impact of videotaped information on frequency and confidence of breast self-examination.

BACKGROUND: Videotaped education materials to teach breast self-examination (BSE) are used worldwide. However, evaluation of videotaped BSE instructions is lacking. METHODS: Premenopausal women (mean age 33.4+/-11.2 years) without history of breast cancer were approached to participate in this experimental study and randomly assigned to a video intervention group (VG; n = 130: length of the video = 15 min) or non-video comparison group (NVG; n = 121). All participants answered a questionnaire on BSE behavior and health beliefs. No additional training was given. The total duration of the session including completion of the questionnaire was 15 min for the NVG and 30 min for the VG. Three months later, changes in BSE behavior were compared in the two groups. The influence of health beliefs on actual BSE behavior was investigated as well. RESULTS: Women of both the VG and NVG performed BSE significantly more frequently at follow-up than at baseline. Analysis of covariance, using the baseline BSE-frequency as co-variate and the follow-up BSE frequency as the dependent variable, revealed that women in the VG (adjusted mean = 7.9 times per year, 95%CI = 6.5-9.4) performed BSE more frequently than women of the NVG (adjusted mean = 6.1 times per year, 95%CI = 4.6-7.5) (F = 4.2, df= 2, p = 0.02). Among motivational predictors, having an example of a role model (modeling) was shown by regression analysis to explain the greatest amount of variance (13%) in BSE frequency. CONCLUSION: Use of an educational videotape increased the frequency of BSE among premenopausal women.

Measurement of quality of life in head and neck cancer patients utilizing the quality of life radiation therapy questionnaire.

BACKGROUND: Quality of life (QOL) measures give patients the possibility to express subjective changes in wellbeing. We aimed to translate the radiation specific quality of life questionnaire (QOL-RTI) and the companion head and neck module (H&N) questionnaire into German and to test its reliability, validity and sensitivity. PATIENTS AND METHODS: After translation and final revisions based on qualitative interviews with ten patients, 97 head and neck cancer patients were screened for eligibility. Patients answered the 38 items questionnaire at baseline and twice in week 4 of radiotherapy for test-retest reliability. Internal consistency was calculated using Chronbach's alpha. Patients also completed the functional assessment of cancer tool plus head and neck (FACT-G plus H&N) for concurrent validity. Item analyses were performed to test the sensitivity. RESULTS: Chronbach's alpha yielded alpha = 0.85 for the QOL-RTI and alpha = 0.80 for the H&N module, test-retest reliability scores were r = 0.87 and r = 0.83, respectively. The correlation of the QOL-RTI plus H&N and the FACT plus H&N was r = 0.79. Questionnaire sensitivity was supported by significant changes in the mean score of 45.8% of the QOL-RTI items and 78.6% of the H&N items between baseline and week 4 of radiotherapy. CONCLUSIONS: The German version of the QOL-RTI was shown to be a reliable, valid and sensitive tool to assess the quality of life of patients undergoing radiotherapy. The H&N module is useful for patients undergoing treatment for head and neck cancer.