Auditory perception

Informing Healthcare Alarm Design and Use: A Human Factors Cross-Industry Perspective

Background: Alarms are signals intended to capture and direct human attention to a potential issue that may require monitoring, assessment, or intervention and play a critical safety role in high-risk industries. Healthcare relies heavily on auditory and visual alarms. While there are some guidelines to inform alarm design and use, alarm fatigue and other alarm issues are challenges in the healthcare setting. Automotive, aviation, and nuclear industries have used the science of human factors to develop alarm design and use guidelines. These guidelines may provide important insights for advancing patient safety in healthcare. Methods: We identified documents containing alarm design and use guidelines from the automotive, aviation, and nuclear industries that have been endorsed by oversight agencies. These guidelines were reviewed by human factors and clinical experts to identify those most relevant to healthcare, qualitatively analyze the relevant guidelines to identify meaningful topics, synthesize the guidelines under each topic to identify key commonalities and differences, and describe how the guidelines might be considered by healthcare stakeholders to improve alarm design and use. Results: A total of 356 guidelines were extracted from industry documents (2012–present) and 327 (91.9%) were deemed relevant to healthcare. A qualitative analysis of relevant guidelines resulted in nine distinct topics: Alarm Reduction, Appropriateness, Context-Dependence, Design Characteristics, Mental Model, Prioritization, Specificity, Urgency, and User Control. There were several commonalities, as well as some differences, across industry guidelines. The guidelines under each topic were found to inform the auditory or visual modality, or both. Certain guidelines have clear considerations for healthcare stakeholders, especially technology developers and healthcare facilities. Conclusion: Numerous guidelines from other high-risk industries can inform alarm design and use in healthcare. Healthcare facilities can use the information presented as a framework for working with their technology developers to appropriately design and modify alarming technologies and can evaluate their clinical environments to see how alarming technologies might be improved.

A Dynamic Representation Solution for Machine Learning-Aided Performance Technology

This paper illuminates some root causes of confusion about dynamic representation in music technology and introduces a system that addresses this problem to provide context-dependent dynamics for machine learning-aided performance. While terms used for dynamic representations like forte and mezzo-forte have been extant for centuries, the canon gives us no straight answer on how these terms must be applied to literal decibel ranges. The common conception that dynamic terms should be understood as context-dependent is ubiquitous and reasonably simple for most human musicians to grasp. This logic breaks down when applied to digital music technologies. At a fundamental level, these technologies define all musical parameters using discrete numbers, rather than with continuous data, making it impossible for these technologies to make context-dependent decisions. The authors give examples in which this lack of contextual inputs in music technology often leads musicians, composers, and producers to ignore dynamics altogether as a concern in their given practice. The authors then present a system that uses an adaptive process to maximize its ability to hear relevant audio events, and which establishes its own definition for context-dependent dynamics for situations involving music technologies. The authors also describe a generative program that uses these context-dependent dynamic systems in conjunction with a Markov model culled from a living performer–composer as a choice engine for new music improvisations.

The development of auditory functions

Typical development and maturation of the auditory system, at both the peripheral and central levels, is essential for the acquisition of speech, language, and auditory skills. The peripheral system generally encodes three basic parameters associated with auditory stimuli-time, frequency, and intensity. These acoustic cues are subsequently processed by the central auditory structures to reach and be perceived by the cerebral cortex. Observations of the human fetal and neonatal ear indicate that the peripheral auditory system is structurally and functionally adult-like at birth. In contrast, the central auditory system exhibits progressive anatomical and physiologic changes until early adulthood. Enriched experience with sound is fundamental and critical to auditory development. The absence of early and prolonged acoustic stimulation delays neuronal maturation, affecting the central auditory nervous system, in particular, and leading to atypical development. The present chapter reviews the various stages of development of the auditory system structures, especially the embryology of the human ear, before briefly presenting the trajectories of typical development of auditory abilities from infants to school-aged children.