Er bestaat een nauwe samenhang tussen de smaak- en de reukperceptie.De smaakperceptie vindt plaats door smaakpapillen die zout, zuur, zoet, bitter en umami kunnen onderscheiden. Daarnaast kunnen 2.000-4.000 verschillende geuren worden herkend. Veel smaakstoornissen zijn in feite reukstoornissen. Speeksel beïnvloedt de smaakperceptie omdat het fungeert als oplosmiddel voor de smaakstoffen en omdat het de smaakreceptoren beschermt. Daarom leidt een vermindering van de speekselproductie gewoonlijk tot afname van de smaakperceptie, waarbij de concentratie van zinkionen en specifieke eiwitten in speeksel een belangrijke rol spelen. Ook zink- en ijzerdeficiëntie kunnen leiden tot verminderde smaak- en reukperceptie.
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Safety at work The objective of the project Safety at Work is to increase safety at the workplace by applying and combining state of the art artefacts from personal protective equipment and ambient intelligence technology. In this state of the art document we focus on the developments with respect to how (persuasive) technology can help to influence behaviour in a natural, automatic way in order to make industrial environments safer. We focus on personal safety, safe environments and safe behaviour. Direct ways to influence safety The most obvious way to influence behaviour is to use direct, physical measures. In particular, this is known from product design. The safe use of a product is related to the characteristics of the product (e.g., sharp edges), the condition of people operating the product (e.g., stressed or tired), the man-machine interface (e.g., intuitive or complex) and the environmental conditions while operating the product (e.g., noisy or crowded). Design guidelines exist to help designers to make safe products. A risk matrix can be made with two axis: product hazards versus personal characteristics. For each combination one might imagine what can go wrong, and what potential solutions are. Except for ‘design for safety’ in the sense of no sharp edges or a redundant architecture, there is a development called ‘safety by design’ as well. Safety by design is a concept that encourages construction or product designers to ‘design out’ health and safety risks during design development. On this topic, we may learn from the area of public safety. Crime Prevention Through Environmental Design (or Designing Out Crime) is a multi-disciplinary approach to deterring criminal behaviour through environmental design. Designing Out Crime uses measures like taking steps to increase (the perception) that people can be seen, limiting the opportunity for crime by taking steps to clearly differentiate between public space and private space, and promoting social control through improved proprietary concern. Senses Neuroscience has shown that we have very little insight into our motivations and, consequently, are poor at predicting our own behaviour. It seems emotions are an important predictor of our behaviour. Input from our senses are important for our emotional state, and therefore influence our behaviour in an ‘ambient’ (invisible) way. The first sense we focus on is sight. Sight encompasses the perception of light intensity (illuminance) and colours (spectral distribution). Several researchers have studied the effects of light and colour in working environments. Results show, e.g., that elderly people can be helped with higher light levels, that cool colours like blue and green have a relaxing effect, while long-wavelength colours such as orange and red are stimulating and give more arousal, and that concentration and motivation of pupils at school can be influenced with light and colour settings. Identically, sound (hearing) has physiological effects (unexpected sounds cause extra cortisol -the fight or flight hormone- and the opposite for soothing sounds), psychological effects (sounds effect our emotions), cognitive effects (sounds effect our concentration) and behavioural effects (the natural behaviour of people is to avoid unpleasant sounds, and embrace pleasurable sounds). Smell affects 75% of daily emotions and plays an important role in memory, itis also important as a warning for danger (gas, burning smell). Research has shown that smell can influence work performance. Haptic feedback is a relative new area of research, and most studies focus on haptic feedback on handheld and automotive devices. Finally, employers have a duty to take every reasonable precaution to protect workers from heat stress disorders. Influence mechanisms: Cialdini To influence behaviour, we may learn from marketing psychology. Robert Cialdini states that if we have to think about every decision
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Aim: Participation of adolescents with autism spectrum disorder hardly occurs in settings outside of home and school. Little is known about how their participation is influenced by environmental factors. This study explored how and why adolescents with autism spectrum disorder perceive aspects of their environment as facilitators or barriers to their participation outside of home and school. Method: This explanatory case study explored the participation experiences of adolescents with autism spectrum disorder (15–21 years) from Zurich and surroundings with in-depth interviews and photo-elicitation, using photos made by the participants during activities outside of home and school. Data was analysed with a 7-step procedure. Result: The presence of two main themes seemed necessary to facilitate participation outside of home and school: “environmental prerequisites to attend activities”, which consists of five subthemes, such as “the company of trusted persons” and “the provision of knowledge and information”, and “social interchange and engagement”, which consists of three subthemes and describes how actual involvement can be supported. Conclusion: Our findings highlight the influence of trusted persons on adolescents with autism spectrum disorder, and the need to extend the support network for these adolescents to other individuals, services and society so that their participation in activities can be encouraged.
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Aim: Participation of adolescents with autism spectrum disorder hardly occurs in settings outside of home and school. Little is known about how their participation is influenced by environmental factors. This study explored how and why adolescents with autism spectrum disorder perceive aspects of their environment as facilitators or barriers to their participation outside of home and school. Method: This explanatory case study explored the participation experiences of adolescents with autism spectrum disorder (15–21 years) from Zurich and surroundings with in-depth interviews and photo-elicitation, using photos made by the participants during activities outside of home and school. Data was analysed with a 7-step procedure. Result: The presence of two main themes seemed necessary to facilitate participation outside of home and school: “environmental prerequisites to attend activities”, which consists of five subthemes, such as “the company of trusted persons” and “the provision of knowledge and information”, and “social interchange and engagement”, which consists of three subthemes and describes how actual involvement can be supported. Conclusion: Our findings highlight the influence of trusted persons on adolescents with autism spectrum disorder, and the need to extend the support network for these adolescents to other individuals, services and society so that their participation in activities can be encouraged.
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Whitepaper van het project ConsuBETER, waarin cijfers,oorzaak en gevolg, eiwitbehoefte en -inname en mogelijke oplossingsrichtingen worden besproken.
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The design of healthcare facilities is a complex and dynamic process, which involves many stakeholders each with their own set of needs. In the context of healthcare facilities, this complexity exists at the intersection of technology and society because the very design of these buildings forces us to consider the technology–human interface directly in terms of living-space, ethics and social priorities. In order to grasp this complexity, current healthcare design models need mechanisms to help prioritize the needs of the stakeholders. Assistance in this process can be derived by incorporating elements of technology philosophy into existing design models. In this article, we develop and examine the Inclusive and Integrated Health Facilities Design model (In2Health Design model) and its foundations. This model brings together three existing approaches: (i) the International Classification of Functioning, Disability and Health, (ii) the Model of Integrated Building Design, and (iii) the ontology by Dooyeweerd. The model can be used to analyze the needs of the various stakeholders, in relationship to the required performances of a building as delivered by various building systems. The applicability of the In2Health Design model is illustrated by two case studies concerning (i) the evaluation of the indoor environment for older people with dementia and (ii) the design process of the redevelopment of an existing hospital for psychiatric patients.
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The purpose of this study was to describe the care needs of adult traumatized refugees and asylum seekers. DESIGN AND METHODS. A mixed-methods design was used. A survey was conducted using the Camberwell Assessment of Need (CAN) among 30 patients. Semistructured in-depth interviews were subsequently conducted with eight of these patients. FINDINGS. Key themes among refugees are loneliness and grief. Refugees are in severe psychological distress. They also encounter all kinds of practical problems that influence their quality of life. Furthermore, many of them suffer from serious psychiatric and trauma-related problems. PRACTICE IMPLICATIONS. The results of this explorative study can contribute to the quality of care for traumatized refugees.
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Background: Regular inspection of the oral cavity is required for prevention, early diagnosis and risk reduction of oral- and general health-related problems. Assessments to inspect the oral cavity have been designed for non-dental healthcare professionals, like nurses. The purpose of this systematic review was to evaluate the content and the measurement properties of oral health assessments for use by non-dental healthcare professionals in assessing older peoples’ oral health, in order to provide recommendations for practice, policy, and research. Methods: A systematic search in PubMed, EMBASE.com, and Cinahl (via Ebsco) has been performed. Search terms referring to ‘oral health assessments’, ‘non-dental healthcare professionals’ and ‘older people (60+)’ were used. Two reviewers individually performed title/abstract, and full-text screening for eligibility. The included studies have investigated at least one measurement property (validity/reliability) and were evaluated on their methodological quality using “The Consensus-based Standards for the selection of health Measurement Instruments” (COSMIN) checklist. The measurement properties were then scored using quality criteria (positive/negative/indeterminate). Results: Out of 879 hits, 18 studies were included in this review. Five studies showed good methodological quality on at least one measurement property and 14 studies showed poor methodological quality on some of their measurement properties. None of the studies assessed all measurement properties of the COSMIN. In total eight oral health assessments were found: the Revised Oral Assessment Guide (ROAG); the Minimum Data Set (MDS), with oral health component; the Oral Health Assessment Tool (OHAT); The Holistic Reliable Oral Assessment Tool (THROAT); Dental Hygiene Registration (DHR); Mucosal Plaque Score (MPS); The Brief Oral Health Screening Examination (BOHSE) and the Oral Assessment Sheet (OAS). Most frequently assessed items were: lips, mucosa membrane, tongue, gums, teeth, denture, saliva, and oral hygiene. Conclusion: Taken into account the scarce evidence of the proposed assessments, the OHAT and ROAG are most complete in their included oral health items and are of best methodological quality in combination with positive quality criteria on their measurement properties. Non-dental healthcare professionals, policymakers and researchers should be aware of the methodological limitations of the available oral health assessments and realize that the quality of the measurement properties remains uncertain.
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Abstract: Hypertension is both a health problem and a financial one globally. It affects nearly 30 % of the general population. Elderly people, aged ≥65 years, are a special group of hypertensive patients. In this group, the overall prevalence of the disease reaches 60 %, rising to 70 % in those aged ≥80 years. In the elderly population, isolated systolic hypertension is quite common. High systolic blood pressure is associated with an increased risk of cardiovascular disease, cerebrovascular disease, peripheral artery disease, cognitive impairment and kidney disease. Considering the physiological changes resulting from ageing alongside multiple comorbidities, treatment of hypertension in elderly patients poses a significant challenge to treatment teams. Progressive disability with regard to the activities of daily life, more frequent hospitalisations and low quality of life are often seen in elderly patients. There is discussion in the literature regarding frailty syndrome associated with old age. Frailty is understood to involve decreased resistance to stressors, depleted adaptive and physiological reserves of a number of organs, endocrine dysregulation and immune dysfunction. The primary dilemma concerning frailty is whether it should only be defined on the basis of physical factors, or whether psychological and social factors should also be included. Proper nutrition and motor rehabilitation should be prioritised in care for frail patients. The risk of orthostatic hypotension is a significant issue in elderly patients. It results from an autonomic nervous system dysfunction and involves maladjustment of the cardiovascular system to sudden changes in the position of the body. Other significant issues in elderly patients include polypharmacy, increased risk of falls and cognitive impairment. Chronic diseases, including hypertension, deteriorate baroreceptor function and result in irreversible changes in cerebral and coronary circulation. Concurrent frailty or other components of geriatric syndrome in elderly patients are associated with a worse perception of health, an increased number of comorbidities and social isolation of the patient. It may also interfere with treatment adherence. Identifying causes of non-adherence to pharmaceutical treatment is a key factor in planning therapeutic interventions aimed at increasing control, preventing complications, and improving long-term outcomes and any adverse effects of treatment. Diagnosis of frailty and awareness of the associated difficulties in adhering to treatment may allow targeting of those elderly patients who have a poorer prognosis or may be at risk of complications from untreated or undertreated hypertension, and for the planning of interventions to improve hypertension control.
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Objective: To report the study protocol and baseline characteristics of a prospective cohort study to evaluate longitudinal recovery trajectories of patients recovering from COVID-19 who have visited a primary care allied health professional. Design: Report of the protocol and baseline characteristics for a prospective cohort study with a mixed-methods approach. Patients: Patients recovering from COVID-19 treated by primary care dietitians, exercise therapists, occupational therapists, physical therapists and/or speech and language therapists in the Netherlands. Methods: The prospective study will measure primary outcome domains: participation, health-related quality of life, fatigue, physical functioning, and costs, at baseline, 3, 6, 9 and 12 months. Interviews, on the patients’ experiences with allied healthcare, will be held with a subsample of patients and allied health professionals. Results: The cohort comprises 1,451 patients (57% female, mean age 49 (standard deviation 13) years). Preliminary results for the study cohort show that 974 (67%) of the participants reported mild/moderate severity symptoms during the infection period and patients reported severe restrictions in activities of daily living compared with previous research in other patient populations. Both quantitative and qualitative, will provide insight into the recovery of patients who are treated by allied health professionals. Conclusion: In conclusion, this will be the first comprehensive study to longitudinally evaluate the recovery trajectories and related costs of patients recovering from COVID-19 who are treated by allied health professionals in the Netherlands. This study will provide evidence for the optimal strategy to treat patients recovering from COVID-19 infection, including which patients benefit, and to what extent, from treatment, and which factors might impact their recovery course over time. The preliminary results of this study demonstrated the severity of restrictions and complaints at the start of therapy are substantial.
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