Mobile Phone use: Reaction Times

Mobile Phone use: Reaction Times The purpose of this study was to determine the effects of divided attention upon response time. Participants consisted of 51 female and 10 male students from the University of Canberra, ranging in age from 19- 60 years (M = 24.95, SD = 7.99). Participants were asked to complete a spatial cueing task while using their mobile phone to either send text messages or make phone calls. Data was collected using the universities computers on the program Cog Lab 2.0. Results revealed that the text and talk conditions for all task types (neutral, valid, and invalid) had significantly slower reaction times than the control condition. The text group showed significantly slower reaction times than the talk group. Furthermore, the control group showed that the reaction times for the valid tasks was significantly faster than the neutral, and significantly faster for the valid than invalid tasks. These results do support previous research and literature in the area of mobile phone use while driving. The use of mobile phones has grown over the last five years, with over 21.26 million users in Australia alone (White, Hyde, Walsh Watson, 2010). Despite increasing evidence that mobile phone use while driving presents risks; drivers still engage in this behaviour. A self- report study on mobile phone use while driving in Australia, found that 43 percent of mobile phone owners use their phones while driving to answer their calls, followed by making calls 36 percent, reading text messages 27 percent, and sending text messages 18 percent. Approximately a third of these drivers used hand free units, indicating that most Australian drivers use hand held mobile phones while driving (White Watson, 2010). The impairment potential of mobile phone usage while driving has been the focus of various behavioural and experimental studies. Although these studies differ in the extent of behavioural changes found, most researchers agree that there is a significant negative effect on different aspects of driving performance. The most common aspects are the withdrawal of attention and slower reaction times (Reed Green, 1999). The impact of driving while using a mobile phone on reaction time is often explained with reference to a phenomenon commonly referred to as inattentional blindness or change blindness (Strayer, Drews Johnston, 2003), wherein a person who is focusing attention on one particular task will fail to notice an unexpected stimulus even while directly looking at it (Simons Chabris, 1999). Strayer and Johnston (2003), determined that drivers conversing on a hands free mobile phone were more likely than drivers not using mobile phones to fail to notice traffic signals and respond slower to brake lights. As a result drivers were more likely to cause rear end accidents and less likely to be able to recall detailed information about specific visual stimuli (Strayer et al., 2003). These researchers also found this behaviour in participants who fixated their vision, suggesting that mobile phone conversations may induce inattentional blindness in the context of driving. However, Strayer Johnston (2003) considered that because they used a high- fidelity driving simulator that these results were conclusive of real life driving. These results may not be accurate in real life scenarios were participants would be driving on real roads with real vehicles. Beede Kass, (2006) also used a driving simulator to measure the impact of a conversation task on a hands free mobile phone and a signal detection task while driving. Results suggested driving performance in terms of traffic violations, was significantly impaired while participants converse on the hands free unit and overall performance in the signal detection task were low. Finally they found an interaction between the mobile phone conversation and a signal detection task in measures of speed, speed variability, reaction time and attention lapses (Beede Kass, 2006). However, drivers that are not subjected to distracting tasks may also fail to notice important features of the traffic environment. That is, even when scanning different parts of the visual scene appropriately, there is a risk that important features will be missed in unattended areas (Simons Chabris, 1999). In considering the phenomena of inattentional blindness, it is worth reiterating a key modifier, unexpected events. Generally, the occurrence of these inattentional failures seems to be reduced when the observer anticipates the object. Therefore, the unexpected events seem to be the most problematic. In the context of traffic, these may be somewhat harder to define quantitatively because these events can take on many different forms (Simons Chabris, 1999). A study conducted by Posner, Snyder Davidson, (1980) using a spatial cueing task, looked into the theory of expected versus unexpected events. They believe that participants responses to cued targets are usually faster and sometimes more accurate than responses to uncued targets. Results from the study conducted by Posner et al., (1980) suggest that participants were faster when the cue appeared in the same location (valid) and slowest when the cue appeared opposite the indicated cue (invalid). Posner, Snyder and Davidson, (1980) interpreted these results as showing that participants shifted their attention to the location of the target prior to its appearance. Equally, when participants were expecting the cue to appear in the opposite area, participants shifted attention to the wrong location. However, it may be possible to describe these results as being due to participants anticipation of the target position, or even chance. Alternatively, Simons Chabris (1999) provided a review of experiments in which participants focusing on visual tasks fail to notice unexpected visual stimuli, and present their own seminal explanation of the phenomenon. Results suggest that the probability of noticing the unexpected object depended on the similarity of the particular object within the display and the difficulty of the task. Simons Chabris (1999) add that the spatial proximity of the object to attended location did not affect the detection, suggesting that participants attend to objects and events, not positions (Simons et al., 1999). However, this study did not explore whether individual differences in noticing, take place from differences in the ability to perform the primary task. Strayer, Drews Crouch (2006) compared drivers using mobile phones to drunk drivers, concludingthat when controlling for driving difficulty and time on task, mobile-phone drivers exhibited a greater impairment than intoxicated drivers. Results of this study found that the reaction time of drivers using a mobile phone were slower by 8.4 percent relative to drivers who neither had consumed alcohol nor were using phones. Also drivers using mobile phones were actually more likely to have a rear- end crash than drivers who had consumed alcohol (Strayer Crouch, 2003). The impact of using a hands free phone on driving performance was not found to differ from the impact of using a hand held phone, which researchers suggested was due to the withdrawal of attention from the processing of information in the driving environment while engaging in mobile phone conversation (Strayer et al., 2003). However, the measures used for the two impairments mentioned above, are quite unusual. Mobile phone i mpairment is associated with the diversion of attention and is temporary, while the impairment from alcohol persists for longer periods of time. Furthermore, while mobile phone users have some kind of control (e.g. pausing a conversation) drivers who are intoxicated cannot do much to control their performance. Studies that have looked at the effects of texting while driving have also suggested a negative impact on drivers performance (Drews, Yazdani, Celeste, Godfrey Cooper, 2009). Research by Drews Cooper (2009) found a lack of response time in participants who used their mobile phones to send text messages while driving on a simulator. They concluded the texters in the driving simulator had more crashes, responded more slowly to the brake lights of cars in front of them- and showed more impairment in forward and sideways control than drivers who talked on their mobile phones while driving. (Drews et al. also found that text messaging participants longest eyes off the road duration was over six seconds. At 55mph this equates to a driver travelling the length of a football field without looking at the roadway. In summary, the purpose of this study is to explore the effects of divided attention on response time. To achieve this purpose, this study aims to measure response times in the neutral, valid, and invalid conditions of a spatial cueing task, while participants use their mobile phones to talk or text. Based on both theory and past research, it is hypothesised that the control group will have significantly faster reaction times over all groups (text and talk). It was also hypothesised that the reaction times for the control group across all task types (valid, invalid, and neutral) would be significantly different. More specifically, it was predicted that the task type for the valid condition would be faster than the neutral task, and significantly faster for the valid than the invalid task. It was hypothesised that there would be a significant difference between participants reaction times within the talk group across all three conditions (valid, invalid, and neutral) in contrast to th e text group. More specifically it was predicted that the reaction times for the talk group will be significantly faster overall compared to the text group. Method Participants The participants of this study consisted of 61 graduate and undergraduate students of the unit cognitive psychology, from the University of Canberra (51 female and 10 male). Ages ranged from 19 to 60 years (M = 24.95, SD = 7.99). Participants were allocated a condition based on their tutorial group. Tutorial one were allocated to the text condition, this group included 20 participants of which two performed the control condition due to non- availability of a mobile phone. Tutorial two participants were allocated to the talk condition, this group included 18 participants, of which one participant did the control condition. Tutorial three and four participants were allocated to the control condition, this group included 24 participants, of which three participants did the text condition. One participant was excluded from the study, as they did not record their mean response times. Materials All 61 participants were given a spatial cueing task on the universities computer during class tutorials. Participants used the computer program Cog Lab 2.0 to view and complete the cueing task. Each participant was given an instruction sheet as per his / her tutorial group. Participants within the text and talk condition used their own personal mobile phone. Procedure Student participants were divided into three groups as arranged by their tutorial time and group. These groups comprised of three conditions text, talk, and control. While in tutorials participants were given an instruction sheet and told to follow the instructions as per their group category (text, talk, or control). In order to maintain confidentiality participants were asked to select and record a code name. They were than asked to give their age, gender, and identify the group they had been assigned to. Each group of participants were given a set of instructions that were unique to their own group. The text group were told to complete the spatial cueing exercise while writing and sending three text messages. They were instructed not to answer their phone or talk to anyone else during the experiment. The talk group were instructed to make a series of short calls or one long call while taking part in the experiment. They were also told not to answer the phone or talk to any one else in the room. The control group were given instructions to focus only on the experiment and give it the same attention they would if driving a car on a busy road. They were told not to talk on the phone, message, or talk to anyone else in the room. Participants were then asked to complete the spatial cueing task on the computer (Cog Lab 2.0) per their assigned group. Design Variables: The independent variable in this study was the mobile phone = 3 levels, the dependant variable was response time. Results Effect of Condition on Reaction Time Mean reaction times for the Text group were slower than for the Talk group, and those for the Talk group were slower than the Control group. Mean reaction times for each condition on the Neutral, Valid and Invalid tasks are shown below in Figure 1. Figure 1. Mean reaction time for control, text and talk conditions across neutral, valid and invalid spatial cueing tasks. A Kruskal-Wallis ANOVA indicated a significant difference in reaction times across Control (Mean Rank = 15.0), Talk (Mean Rank = 31.3), and Text (Mean Rank = 48.3) conditions, H(2,61) = 38.60, p The significance level was reset to p = .02 using a Bonferroni correction. A Mann-Whitney U tests indicated that the Text group (Mean Rank = 33.48 for Neutral task, Mean Rank = 33.95 for Valid task, Mean Rank = 33.0 for Invalid task, n = 21) had significantly slower reaction times than the Control group (Mean Rank = 12.48 Neutral task, Mean Rank = 12.04 Valid task, Mean Rank = 12.91 Invalid task, n = 23), U = 11.0, z = -5.416;U = 1.0, z = -5.181; U = 21.0, z = -5.651; (corrected for ties), p Follow-up Mann-Whitney U tests indicated that the Talk group (Mean Rank = 28.59, Mean Rank = 29.24, Mean Rank = 28.18, n = 17) also had significantly slower reaction times than the Control group (Mean Rank = 14.52 Neutral task, Mean Rank = 14.04 Valid task, Mean Rank = 14.83 Invalid task, n = 23), U = 58.0, z = -3.762; U = 47.0, z = -4.063; U = 65.0, z = -3.57; (not corrected for ties) , p Follow-up Mann-Whitney U tests indicated the Text group (Mean Rank = 25.81, Mean Rank = 26.86, Mean Rank = 26.05, n = 21) had significantly slower reaction times than the Talk group (Mean Rank = 11.71 Neutral task, Mean Rank = 10.41 Valid task, Mean Rank = 11.41 Invalid task, n = 17), U = 46.0, z = -3.89; U = 24.0, z = -4.536; U = 41.0, z = -4.037; (not corrected for ties), p Effect of Task Type on Reaction Time A Friedman ANOVA showed there was a significant difference in reaction times across task type for the control group, à Ã¢â‚¬ ¡2(2) = 24.09, p Discussion This study explored the effects of divided attention on response time. The results of the Kruskal-Wallis ANOVA did show a significant difference between reaction times across all three conditions (control, talk and text). However this analysis leaves the ambiguous situation of not knowing which condition/s differed more so than others. A second analysis was performed, this revealed that response times for the text group across all task types (valid, invalid, and neutral) were significantly slower than the control group, the effect was large. Results also revealed that the response times for the talk group across all task types were significantly slower than the control group; the effect was medium to large. These results are consistent with the first hypothesis. Previous studies much more scientific than ours, conducted in vehicle simulators have also found a significant relationship between similar aspects of texting, talking, and driving. However, drawing comparisons between this s tudies results and past studies results, issues arise over the current studies methods. This study was not employed in a driving simulator, nor was the task undertaken in a real driving environment or vehicle. Participant simply sat in front of a computer in a class room where they were told to imagine driving a car on a busy road. There is no possible way this would accurately represent actual driver duties or a real driving environment. The sample size is also quite questionable and would not represent the current driving population. A future benefit for this study would be to create a more legitimate driving environment and increase the sample size. The results of the fourth analysis also supported the hypothesis; these results showed the text group to have significantly slower reaction times than the talk group across all task types, the effect was large. Results are also consistent with past research on texting, driving and mobile phone use. Although, this study was not performed in a real or simulated driving environment these results were expected because texting required the participants to remove their eyes and attention away from the computer screen. However, these results only indicated a difference between reaction times, they do not suggest where the difference lies or how much interference can be attributed to the manual manipulation of the phone (e.g. texting), or how much can be attributed to the demands placed on attention by the phone conversation. A benefit to future studies would be to measure each one of these underlining factors separately and then compare those with other activities commonly engaged during dr iving. The last analysis showed there was a significant difference in reaction times across task type for the control group. More specifically results showed reaction time for valid tasks to be significantly faster than for neutral tasks, and significantly faster for the valid than the invalid. These effects were described as large. This result also supports the hypothesis and the previous study conducted by Posner and Davidson, (1980). However, most spatial cueing experiments including this one have been concerned with the effect of directing attention on the detection of stimuli. Little has been done on the influence of visual attention on higher-level cognitive tasks, i.e., where a response would involve making a decision between two or more alternatives (Johnston, McCann Remington, 1995). According to Johnston et al. (1995) responding to a higher-level cognitive task and detecting a stimulus may only be the first stage or a single process in a series of mental procedures involved in th e response. Directing attention to the location of the stimulus might result in faster detection of the stimulus. It may be beneficial for this study and others like it to explore this theory more comprehensively. References Beede, K. E., Kass, S. T. (2006). Engrossed in conversation: The impact of cell phones on simulated driving performance. Accident Analysis Prevention, 38, 415-421. Retrieved from http://www.Canberra.edu.au/library Drews, F. A., Yazdani, H., Celeste, N., Godfrey, Cooper, J. M., Strayer, D. L. (2009). Text Messaging during simulated driving. Journal of Human Factors and Ergonomics Society, 51, 762-770. Johnston, J. C., McCann, R. S., Remington, R. W. (1995). Chronometric evidence for two types of attention. Journal of Psychological Sciences, 6, 365-386. Posner, M. I., Snyder, R. R., Davidson, B. J. (1980). Attention and the detection of signals, Journal of Experimental Psychology, 109, 160-174. Reed, M. P., Green, P. A. (1999). Comparison of driving performance on-road and in a low-cost simulator using a concurrent telephone dialling task. Ergonomics, 42, 1015-1037. Simons, D. J., Chabris, C. F. (1999). Gorillas in our midst: Sustained inattentional blindness for dynamic events. Perception, 28, 1059-1074. Strayer, D. L., Drews, F. A., Crouch, D. J. (1999). A comparison of the cell phone driver and the drunk driver. Journal of Human Factors and Ergonomics Society, 48, 381-391. Strayer, D. L., Drews, F. A., Johnston, W. A. (2003). Cell phone- induced failures of visual attention during simulated driving. Journal of Experimental Psychology, 9, 23-32. White, K. M., Hyde, M. K., Walsh, S. P., Watson, B. (2010). Mobile phone use while driving: An investigation of the beliefs influencing drivers hands- free and hand- held mobile phone use. Journal of Traffic Psychology and Behaviour, 13, 9-20. Retrieved from http://www. canberra.edu.au/library Self-evaluation Form for Cognitive Psychology 2010 Lab Report For each item in the table, highlight or bold the description that fits your work for that component of the lab report. HD D CR P F Title n/a n/a n/a > 12 words Abstract concise, accurate and elegant description of problem, participants, experimental conditions, method, results, and conclusion. concise and accurate description of problem, participants, experimental conditions, method, results, and conclusion. 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future research projects D accurate and competent discussion of problems, limitations and generalisability of the study, and implications for future research projects discussion of problems, limitations and generalisability of the study, and implications for future research projects little or no discussion of problems, limitations or generalisability of the study, or implications for future research projects Norovirus: Causes and Solutions Norovirus: Causes and Solutions Contents Origin and spread of the Norovirus: Symptoms: Transmission in health care facility: Prevention of Norovirus: Preventive measures for spread of virus in health care facility: Early (or primary) control actions: Control of transmission at the ward level: Specific Nursing care for patients: Personal care: Proper hand hygiene: Extra care: Bibliography Essay Origin and spread of the Norovirus: Norovirus, occasionally acknowledged as the winter vomiting bug in the United Kingdom, is the utmost common reason of viral gastroenteritisin human beings. It affects individuals of all ages. The virus is transferred byfecally polluted water or food, by person-to-person interaction and through aerosolization of the disease and following adulteration of surfaces.The virus affects about 267 million individuals and reasons above 200,000 deceases every year; these deaths are frequently in less advanced republics and in the very young, aged and immunosuppressed. Norovirus infection is categorized by watery diarrhoea, forceful vomiting, nausea, abdominal pain, and in several cases, general lethargy, muscle aches, loss of taste, headache, weakness and low-grade fever may arise. The illness is typically self-limiting, and severe sickness is rare. Though having norovirus can be spiteful, it is not generally hazardous and most that contact it make a full retrieval in a couple of days. Norovirus is speedily disabled by either adequate heating or by chlorine based disinfection, but the virus is less vulnerable to alcohols and cleaners. (Ben Lopman, 2011) Aftercontamination,resistanceto norovirus is usually partial and momentarywith one publication drawing the deduction that defensive immunity to the similar pressure of norovirus continues for six months, but that all such resistance is disappeared after two years. Outbursts of norovirus contagion often happen in closed or semi closed societies, such as long-term care amenities, overnight campsites, clinics, schools, dormitories, prisons, and cruise ships, where the contamination spreads very speedily either by person-to-person spread or through polluted food. Numerous norovirus outbursts have been outlined to food that was controlled by one infected individual. (Sears, 2008) The species name  Norovirusis derivative of Norwalk virus, the only kind of the genus. The species causes about 90% of epidemicnonbacterial outbursts of gastroenteritisround the domain,and may be accountable for 50% of all foodborne outbursts of gastroenteritis in the USA. Symptoms: Symptoms recorded by the Centres for Disease Control and Prevention (2011) contain vomiting, non-bloody diarrhoea with stomach cramps and biliousness. These seem following a development period of 24-48 hours, though there are examples where signs present after only 12 hours succeeding disclosure to the virus.(Mcgeary, 2012) Blacklow (1996) found grown-up volunteers injected with the virus established a momentary mucosal laceration of the proximal minor intestine but had no colon association; this proposes norovirus infection frees the large intestine; hereafter faecal leucocytes do not exist in stool testers. This feature has been used to aid distinguish the contamination from others such as salmonellosis, C difficile infection orshigellosis. Transmission in health care facility: Noroviruses are found in the faeces and vomitus of infected individuals. This virus is very spreadable and can feast rapidly through healthcare amenities. People can become infested with the virus in numerous ways: Having straight contact with another individual who is infested (a healthcare employee, guest, or another patient) Ingestion food or drinking fluids that are polluted with norovirus. Touching tops or objects polluted with norovirus, and then touching your face or other food items. (HAIs, 2013) Prevention of Norovirus: In a healthcare capacity, patients with supposed norovirus may be located in isolated rooms or share accommodations with other patients with the identical infection. Extra prevention actions in healthcare amenities can reduce the chance of interacting with noroviruses: Follow hand-hygiene rules, and cautiously washing of hands with cleanser and water after interaction with patients with norovirus contagion. Use robes and gloves when in connection with, or caring for patients who are indicative of norovirus. Regularly clean and sterilize high touch patient exteriors and apparatus with an Environmental Protection Agency-approved produce with a tag claim for norovirus Eliminate and wash polluted clothing or linens Healthcare employees who have signs consistent with norovirus should be barred from work. Preventive measures for spread of virus in health care facility: The virus is characteristically conveyed to persons by the faecal-oral path from fecally polluted foodstuff or water, person-to-person interaction or interaction with polluted fomites. In current institutional outbreaks, airborne spread via vomiting has been suggested as expediting rapid spread of contagion. Once noroviruses are presented onto a region or floor, the contamination may spread speedily through the facility in spite of cohorting and actions to limit the feast of the contaminations. To support in the decision-making procedure for infirmaries and nursing homes when these contaminations happen, the Bureau of Communicable Diseases, Division of Public Health has collected a list of recommended, but not required control actions established from knowledge with organization of earlier hospital eruptions. The movements taken by diverse hospitals or nurturing homes may vary with the sum of cases and degree of spread within the facility. (health protection agency) Early (or primary) control actions: †¢ Once a catalogue case presents within an area, immediate separation of the patient and the instant area is necessary. †¢ Patients inflowing the hospital with indications evocative of norovirus contagions should be admitted straight to a private area until another cause of disease are recognized. †¢ The contamination control staff should be instantly notified about the beginning of the first case. †¢ Infection control run should meet every day to screen the outbreak and assess control actions. †¢ Support enteric defences and strategies to all staff associates. †¢ Staff should be repeated that good hand washing after all patient interaction (washing with warm running water and cleanser for at least 10 seconds) is the utmost operational way of dropping person-to-person feast of contamination. In the absenteeism of running water, alcohol emollient may be used except hands are totally soiled. †¢ The native health officer should be instantly notified once an outburst is alleged. †¢ Indicative patients or inhabitants should be cohorted. †¢ If an outburst lasts consider closing the facility to new admittances. †¢ Pretentious staff must be controlled from patient interaction for 48 hours after termination of signs. (management of norovirus, 2004) Control of transmission at the ward level: †¢ Unluckily, by the time the outburst has been documented on a ward, it is probable the majority of vulnerable patients and employee on duty may have been exposed to the infested agent, mainly if vomiting is an extensive symptom. †¢ Gowns, gloves and masks should be worn every time contact with a diseased patient or polluted atmosphere is expected. †¢ Affected areas or floors should be sealed to new admittances and companions to avoid the introduction of other vulnerable individuals. †¢ Airborne spread may be a noteworthy contributor to the sum of cases since projectile retching could possibly create infectious sprays. Air flows created by open spaces or air conditioning could scatter aerosols extensively. Air streams should be reduced. †¢ Affected areas should persist closed until a 48-hour period has passed with no fresh cases amongst patients or staff. †¢ Non-essential employee should be excluded from pretentious clinical zones. †¢ Reducing the risk of communication from sickness may be problematic. (HPS norovirus outbreak, 2013) The following actions may be valuable and are suggested: †¢ Removal of exposed foodstuffs such as plates of fruit †¢ Rapid washing and fumigation of parts where vomiting has happened with a 0.1% hypochlorite solution (made fresh everyday) †¢ Administration of anti-emetics drugs †¢ Full cleaning routine on all pretentious wards. (Norovirus outbreak prevention toolkit, 2012) Specific Nursing care for patients: Personal care: Patients with Norovirus infestation are very sensitive because this disease is very irritating due to its unbearable symptoms. Nurses should provide such patients great personal care. Nurses must give attention to individual patient for hygiene. Symptomatic treatment is provided to such patients so nurses must provide extra care to patients. Nurses should wear Gowns, gloves and masks all the time and should not move outside of ward frequently to prevent spread of the disease. (Caballero, 2014) Proper hand hygiene: Staff should rinse their hands (or use alcohol-based hand disinfectant) whenever they go in and leave a patient/resident area. Staff may be more directed to achieve hand hygiene at the following intervals: †¢ Particular intermissions (e.g., once per hour) †¢ Upon ingoing to a kitchen †¢ After using the washroom †¢ After shaking hands or other bodily contact with colleagues or visitors †¢ After sneezing †¢ After touching the face of patient †¢ After puffing the nose †¢ After rubbing hands on dress and similar actions †¢ After treating raw foods †¢ After usage of dirty kitchen gears and kitchenware †¢ After sweeping, cleaning, or mopping †¢ After a discontinuity †¢ After eating, smoking, or drinking †¢ Before and afterward using PPE e.g. gloves †¢ Before treating the food, particularly ready-to-eat foods and frost. Though, detailed hand-washing is also significant in keeping gloves or other gears from flattering vehicles for transporting microorganisms to the food. †¢ Preceding to handling or administering any oral medicines †¢ After changing diapers †¢ After handling other possibly polluted objects. (norovirus management toolkit) Extra care: Extra assistance is a need of these patients. Patients of Norovirus are disturbed psychologically due to its irritating symptoms so these patients require extra care and time. Vomits should be cleaned immediately and properly to prevent the airborne spread of this disease. Nurse should be present in ward all the time to provide extra care to these patients. Nurses have very significant role in patient care because they are the only staff in the health care facility that takes care of the medications, hygiene and moods of patients and patients with Norovirus require extra care due to their conditions. Bibliography management of norovirus. (2004, feburary). Retrieved from public health: http://www.publichealthmdc.com/environmental/food/documents/ManagementofNorovirusInfectionOutbreaksinHospitalsandNursingHomes.pdf Norovirus outbreak prevention toolkit. (2012, october). Retrieved from public health country of los angeles: http://publichealth.lacounty.gov/acd/docs/Norovirus/NoroToolkit2012.pdf HAIs. (2013, feburary 25). Retrieved from Centres for disease control and prevention: http://www.cdc.gov/HAI/organisms/norovirus.html HPS norovirus outbreak. (2013, september). Retrieved from national services scotland: http://www.documents.hps.scot.nhs.uk/hai/infection-control/toolkits/norovirus-control-measures-2013-09.pdf Ben Lopman, P. G. (2011, december 11). Environmental transmission of norovirus gastroenteritis §. Retrieved from http://uepa.br/portal/downloads/Lopman2012.pdf Caballero, v. (2014, november 15). role nursing in norovirus outbreak. Retrieved from American public health association: https://apha.confex.com/apha/142am/webprogram/Paper298230.html health protection agency. (n.d.). Retrieved from british infection association: http://www.his.org.uk/files/9113/7398/0999/Guidelines_for_the_management_of_norovirus_outbreaks_in_acute_and_community_health_and_social_care_settings.pdf Mcgeary, t. (2012, feburary 3). how to prevent the spread of norovirus. Retrieved from nursing times: www.nursingtimes.net/how-to-prevent-the-spread-of-norovirus/5040972.article norovirus management toolkit. (n.d.). Retrieved from nevada state health division: http://www.health.nv.gov/PDFs/HSPER/NorovirusManagementToolkitResponsePlan_Version1-1.pdf Sears, T. M. (2008, july 8). Gastrointestinal Flu: Norovirus in Health Care and Long-Term Care Facilities. Retrieved from clinical infectious diseases: http://cid.oxfordjournals.org/content/47/9/1202.long