BackgroundIn a global effort to design better hospital buildings for people and organizations, some design principles are still surrounded by great mystery. The aim of this online study was to compare anxiety in an existing single-bed inpatient hospital room with three redesigns of this room in accordance with the principles of Golden Ratio, Feng Shui, and Evidence-Based Design.MethodsIn this online multi-arm parallel-group randomized trial participants were randomly assigned (1:1:1:1) to one of four conditions, namely Golden Ratio condition, Feng Shui condition, Evidence-Based Design condition, or the control condition. The primary outcomes were anxiety, sense of control, social support, positive distraction, and pleasantness of the room.FindingsBetween June 24, 2022, and August 22, 2022, 558 individuals were randomly assigned to one of the four conditions, 137 participants to the control condition, 138 participants to the Golden Ratio condition, 140 participants to the Feng Shui condition, and 143 participants to the Evidence-Based Design condition. Compared with baseline, participants assigned to the Evidence-Based Design condition experienced less anxiety (mean difference -1.35, 95% CI -2.15 to -0.55, Cohen’s d = 0.40, p < 0.001). Results also showed a significant indirect effect of the Feng Shui condition on anxiety through the pleasantness of the room (B = -0.85, CI = -1.29 to -0.45) and social support (B = -0.33, CI = -0.56 to -0.13). Pleasantness of the room and social support were mediators of change in anxiety in the Evidence-Based Design and Feng Shui conditions. In contrast, application of the design principle Golden Ratio showed no effect on anxiety and remains a myth.InterpretationTo our knowledge, this is the first randomized controlled trial linking design principles directly to anxiety in hospital rooms. The findings of our study suggest that Feng Shui and Evidence-Based Design hospital rooms can mitigate anxiety by creating a pleasant looking hospital room that fosters access to social support.
De laatste jaren bloeit er in bedrijven een gevarieerde spirituele praktijk op: meditatietrainingen, stiltekamers, gebedsgroepen, neurolinguïstisch programmeren, bedrijfsopstellingen, coaching op levensloop- en loopbaanvraagstukken, sensitivitytrainingen en ‘passie in je werk’. De link tussen werk, zelfontplooiing, het transcendente en zingeving wordt hierin expliciet gelegd. In deze bijdrage wil ik allereerst de kenmerken van hedendaagse spiritualiteit bespreken. Daarna zal ik aan de hand van drie voorbeelden (bedrijfsopstellingen, de ‘bedrijfsreading’ en de ‘inspiratievilla’ van een energieleverancier) de hedendaagse spirituele praktijk in bedrijven kenschetsen. Ten slotte laat ik zien dat deze sensitiviteit voor zingeving de christelijke traditie veel kansen biedt.
This research contributes to understanding and shaping systems for OFMSW separation at urban Small and Medium Enterprises (SMEs, such as offices, shops and service providers). Separating SMEs’ organic fraction of municipal solid waste (OFMSW) is both an opportunity and a serious challenge for the transition towards circular cities. It is an opportunity because OFMSW represents approximately 40% of the total waste mass generated by these companies. It is challenging because post-collection separation is not feasible for OFMSW. Therefore, SMEs disposing of waste should separate their solid waste so that processing the organic fraction for reuse and recycling is practical and attainable. However, these companies do not experience direct advantages from the extra efforts in separating waste, and much of the OFMSW ends up in landfills, often resulting in unnecessary GHG emissions. Therefore, governments and waste processors are looking for ways to improve the OFMSW separation degree by urban companies disposing of waste through policies for behaviour change.There are multiple types of personnel at companies disposing of waste. These co-workers act according to their values, beliefs and norms. They adapt their behaviour continuously, influenced by the physical environment, events over time and self-evaluation of their actions. Therefore, waste separation at companies can be regarded as a Socio-Technical Complex Adaptive System (STCAS). Agent-based modelling and simulation are powerful methods to help understand STCAS. Consequently, we have created an agent-based model representing the evolution of behaviour regarding waste separation at companies in the urban environment. The model aims to show public and private stakeholders involved in solid waste collection, transport and processing to what extent behaviour change policies can shape the system towards desired waste separation degrees.We have co-created the model with participants utilising literature and empirical data from a case study on the transition of the waste collection system of a business park located at a former harbour area in Amsterdam, The Netherlands. First, a conceptual model of the system and the environment was set up through participatory workshops, surveys and interviews with stakeholders, domain experts and relevant actors. Together with our case participants, five policies that affect waste separation behaviour were included in the model. To model the behaviour of each company worker’s values, beliefs and norms during the separation and disposal of OFMSW, we have used the Value-Belief-Norm (VBN) Theory by Stern et al. (1999). We have collected data on waste collection behaviour and separation rates through interviews, workshops and a literature study to operationalise and validate the model.Simulation results show how combinations of behaviour profiles affect waste separation rates. Furthermore, findings show that single waste separation policies are often limitedly capable of changing the behaviour in the system. Rather, a combination of information and communication policies is needed to improve the separation of OFMSW, i.e., dissemination of a newsletter, providing personal feedback to the co-workers disposing of waste, and sharing information on the (improvement of) recycling rates.This study contributes to a better understanding of how policies can support co-workers’ pro-environmental behaviour for organic waste separation rates at SMEs. Thus, it shows policymakers how to stimulate the circular transition by actively engaging co-workers’ waste separation behaviour at SMEs. Future work will extend the model’s purpose by including households and policies supporting separating multiple waste types aimed at various R-strategies proposed by Potting et al. (2016).
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