Noise is a common problem in hospitals, and it is known that social behavior can influence sound levels. The aim of this naturally-occurring field experiment was to assess the influence of a non-talking rule on the actual sound level and perception of patients in an outpatient infusion center. In a quasi-randomized trial two conditions were compared in real life. In the control condition, patients (n = 137) were allowed to talk to fellow patients and visitors during the treatment. In the intervention condition patients (n = 126) were requested not to talk to fellow patients and visitors during their treatment. This study measured the actual sound levels in dB(A) as well as patients’ preferences regarding sound and their perceptions of the physical environment, anxiety, and quality of health care. A linear-mixed-model showed a statistically significant, but rather small reduction of the non-talking rule on the actual sound level with an average of 1.1 dB(A). Half of the patients preferred a talking condition (57%), around one-third of the patients had no preference (36%), and 7% of the patients preferred a non-talking condition. Our results suggest that patients who preferred non-talking, perceived the environment more negatively compared to the majority of patients and perceived higher levels of anxiety. Results showed no significant effect of the experimental conditions on patient perceptions. In conclusion, a non-talking rule of conduct only minimally reduced the actual sound level and did not influence the perception of patients.
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Abstract: Existing frailty models have enhanced research and practice; however, none of the models accounts for the perspective of older adults upon defining and operationalizing frailty. We aim to propose a mixed conceptual model that builds on the integral model while accounting for older adults’ perceptions and lived experiences of frailty. We conducted a traditional literature review to address frailty attributes, risk factors, consequences, perceptions, and lived experiences of older adults with frailty. Frailty attributes are vulnerability/susceptibility, aging, dynamic, complex, physical, psychological, and social. Frailty perceptions and lived experience themes/subthemes are refusing frailty labeling, being labeled “by others” as compared to “self-labeling”, from the perception of being frail towards acting as being frail, positive self-image, skepticism about frailty screening, communicating the term “frail”, and negative and positive impacts and experiences of frailty. Frailty risk factors are classified into socio-demographic, biological, physical, psychological/cognitive, behavioral, and situational/environmental factors. The consequences of frailty affect the individual, the caregiver/family, the healthcare sector, and society. The mixed conceptual model of frailty consists of interacting risk factors, interacting attributes surrounded by the older adult’s perception and lived experience, and interacting consequences at multiple levels. The mixed conceptual model provides a lens to qualify frailty in addition to quantifying it.
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In de afgelopen jaren groeide het besef dat veel inwoners die een beroep doen op de publieke dienstverlening de nodige stress en zorgen ervaren. Werkloosheid, hoge schulden of problemen in de opvoeding kunnen eraan bijdragen dat het leven van mensen meer vraagt dan zij aankunnen. Het besef dat chronische stress een wissel trekt op het functioneren heeft een groeiende groep publieke dienstverleners geïnspireerd om in de ondersteuning die zij inwoners bieden, (meer) rekening te houden met de doorwerking van de stress op gedrag. Dat een aanhoudend stroom van zorgen verklaart waarom inwoners die hulp nodig hebben te vaak niet in staat blijken om de processtappen te zetten die van hen worden gevraagd: stukken aanleveren, geen afspraken missen, solliciteren, rondkomen van weekgeld, et cetera. Een van de belangrijkste middelen voor professionals om inwoners te motiveren en te ondersteunen de processtappen toch te zetten is het gesprek. Veel professionals (en hun management) hebben de neiging om vooral aandacht te besteden aan de inhoud van die gesprekken. Een verkenning van studies naar de impact van inrichting op ervaren stress leert dat ook de inrichting van een gebouw kan bijdragen aan stress-sensitieve dienstverlening. Op verzoek van de gemeente Utrecht en in nauwe samenwerking met Studio Sociaal Centraal heeft het lectoraat Schulden en Incasso een literatuurverkenning uitgevoerd om de gemeente Utrecht en andere uitvoerders van publieke dienstverlening op weg te helpen bij het inrichten van ontmoetingsruimten voor professionals die uitvoering geven aan onder meer de schuldhulpverlening, re-integratie, Wmo, jeugdhulpverlening en jeugdgezondheidszorg.
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This study addresses the complex phenomenon of overtourism in the EU. By focusing on a set of case studies, the study reports on overtourism indicators, discusses management approaches implemented within different destinations and assesses policy responses. It concludes that a common set of indicators cannot be defined because of the complex causes and effects of overtourism. Avoiding overtourism requires custom-made policies in cooperation between destinations' stakeholders and policymakers
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This study proposes a framework to measure touristification of consumption spaces, consisting of concentration of retail capital, business displacement and standardization of the consumption landscape. This framework is tested using business registration data and rent price estimates for consumption spaces in Amsterdam between 2005 and 2020. Touristification emerges from concentrations of retail capital and standardization, but occurs without causing significant business displacement. A cluster analysis identifies different variations of touristification. Besides the more typical cases these include nightlife areas, gentrifying consumption spaces and specialized retail areas. This suggests that local contingencies cause consumption spaces to respond differently to increasing tourism.
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Introduction: Retrospective studies suggest that a rapid initiation of treatment results in a better prognosis for patients in the emergency department. There could be a difference between the actual medication administration time and the documented time in the electronic health record. In this study, the difference between the observed medication administration time and documentation time was investigated. Patient and nurse characteristics were also tested for associations with observed time differences. Methods: In this prospective study, emergency nurses were followed by observers for a total of 3 months. Patient inclusion was divided over 2 time periods. The difference in the observed medication administration time and the corresponding electronic health record documentation time was measured. The association between patient/nurse characteristics and the difference in medication administration and documentation time was tested with a Spearman correlation or biserial correlation test. Results: In 34 observed patients, the median difference in administration and documentation time was 6.0 minutes (interquartile range 2.0-16.0). In 9 (26.5%) patients, the actual time of medication administration differed more than 15 minutes with the electronic health record documentation time. High temperature, lower saturation, oxygen-dependency, and high Modified Early Warning Score were all correlated with an increasing difference between administration and documentation times. Discussion: A difference between administration and documentation times of medication in the emergency department may be common, especially for more acute patients. This could bias, in part, previously reported time-to-treatment measurements from retrospective research designs, which should be kept in mind when outcomes of retrospective time-to-treatment studies are evaluated.
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Given that it is essential for hotels to understand how guests experience hospitality, hotel managers need more concrete and tangible insights into this issue to improve their service. Quantitative research on experience of the physical environment and employee contact has shown that the comfort of hotel rooms and an inviting ambience are the factors that most influence guest loyalty. This exploratory paper employs verbal and visual association methods to translate comfortable and inviting into tangible sensory characteristics. Results show association of comfortable with lingering, sitting, resting, natural colours, rounded-off rectangles, and multiple layers. By contrast, inviting is associated with common (meeting) areas such as corridors, white, grey, transparency, and colourful accessories. Visual dataproved suitable for identifying tangible (sensory) characteristics, and delivering concrete recommendations for improving invitingness and comfort.
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De sfeer van een ruimte of omgeving is een belangrijke factor in de beleving van die ruimte door een bezoeker. Om het belang van de factor sfeer te kunnen vaststellen is een goed meetinstrument nodig. In deze studie wordt een voorstel gedaan voor een dergelijk meetinstrument. Hiertoe wordt een meta-analyse uitgevoerd op bestaande empirische en theoretische studies naar sfeer. Deze studies komen uit de marketingliteratuur en uit museum studies. Winkels en musea zijn twee relevante voorbeelden van waar sfeer een evidente rol speelt in de ervaring van bezoekers en hun gedrag. Het is dan ook niet verwonderlijk dat er vanuit deze disciplines redelijk wat aandacht is geweest voor sfeer.
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