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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Er bestaat een nauwe samenhang tussen de reuk- en smaakperceptie.Veel chemosensorische stoornissen die leiden tot eengestoorde smaak zijn in feite reukstoornissen. Aandacht vragendeoorzaken van chemosensorische stoornissen zijn veroudering, hetgebruik van medicamenten, natuurlijke eiwitten, het mondbrandsyndroom,nervustrauma’s, beluchtingsproblemen ter hoogte vanhet reukzintuig, beschadiging van het reukepitheel en oncologischeaandoeningen of de behandeling daarvan. Een chemosensorischestoornis heeft gevolgen voor het genot van voedingsmiddelenen het psychisch welbevinden, kan leiden tot gewichtsverlies ofgewichtstoename en tot te weinig inname van vitaminen en mineralen.De behandeling van een chemosensorische stoornis kanbestaan uit medicatie, een chirurgische correctie, verbetering vande mondgezondheid, reukrevalidatie en voedingsadviezen.
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BACKGROUND AND AIMS: Patients with COVID-19 infection presents with a broad clinical spectrum of symptoms and complications. As a consequence nutritional requirements are not met, resulting in weight- and muscle loss, and malnutrition. The aim of the present study is to delineate nutritional complaints, the (course of the) nutritional status and risk of sarcopenia of COVID-19 patients, during hospitalisation and after discharge.METHODS: In this prospective observational study in 407 hospital admitted COVID-19 patients in four university and peripheral hospitals, data were collected during dietetic consultations. Presence of nutrition related complaints (decreased appetite, loss of smell, changed taste, loss of taste, chewing and swallowing problems, nausea, vomiting, feeling of being full, stool frequency and consistency, gastric retention, need for help with food intake due to weakness and shortness of breath and nutritional status (weight loss, BMI, risk of sarcopenia with SARC-F ≥4 points) before, during hospital stay and after discharge were, where possible, collected.RESULTS: Included patients were most men (69%), median age of 64.8 ± 12.4 years, 60% were admitted to ICU at any time point during hospitalisation with a median LOS of 15 days and an in-hospital mortality rate of 21%. The most commonly reported complaints were: decreased appetite (58%), feeling of being full (49%) and shortness of breath (43%). One in three patients experienced changed taste, loss of taste and/or loss of smell. Prior to hospital admission, 67% of the patients was overweight (BMI >25 kg/m2), 35% of the patients was characterised as malnourished, mainly caused by considerable weight loss. Serious acute weight loss (>5 kg) was showed in 22% of the patents during the hospital stay; most of these patients (85%) were admitted to the ICU at any point in time. A high risk of sarcopenia (SARC-F ≥ 4 points) was scored in 73% of the patients during hospital admission.CONCLUSION: In conclusion, one in five hospital admitted COVID-19 patients suffered from serious acute weight loss and 73% had a high risk of sarcopenia. Moreover, almost all patients had one or more nutritional complaints. Of these complaints, decreased appetite, feeling of being full, shortness of breath and changed taste and loss of taste were the most predominant nutrition related complaints. These symptoms have serious repercussions on nutritional status. Although nutritional complaints persisted a long time after discharge, only a small group of patients received dietetic treatment after hospital discharge in recovery phase. Clinicians should consider the risks of acute malnutrition and sarcopenia in COVID-19 patients and investigate multidisciplinary treatment including dietetics during hospital stay and after discharge.
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