How well prepared are hospitals for future crises? Board members perceive their hospitals as resilient for acute crises.

Resilience is an organizational capacity in day-to-day practice and crisis situation performance. A one of a kind crisis for hospitals is the COVID-19 pandemic. The long duration and magnitude of this crisis offers the opportunity to gain insight into the complexity of crisis management and organizational resilience of hospitals. This interview study therefore explored the organizational resilience of Dutch hospitals during the first 14 months of the COVID-19 pandemic. Nine board members of nine Dutch hospitals were interviewed by means of a semi-structured interview that was built on thirteen indicators of organizational resilience. The results showed that board members considered their hospitals as resilient on almost all indicators. Their judgments varied about how prepared and ready for future crises they considered their hospital. According to board members, hospitals are mainly prepared for "acute" short-term crises, thanks to good crisis leadership, open communication and strong networks. A crisis as long as the COVID-19 pandemic was unprecedented and therefore more difficult to deal with. In between the infection waves, work processes were reflected upon to learn, anticipate and respond more smoothly to successive waves. However, the enduring nature of the COVD-19 crisis presented complex organizational challenges. Crisis operations were eventually scaled down and hospitals had to manage the crisis and regular care as two companies side by side. Each crisis manifests differently. Fostering trust in healthcare staff and allowing them to act autonomously during crises, while diligently monitoring external influences and potential future crises, are therefore paramount in developing organizational adaptive capacities.

Snacking for a reason: detangling effects of socio-economic position and stress on snacking behaviour.

BACKGROUND: As snacking can be considered a cornerstone of an unhealthy diet, investigating psychological drivers of snacking behaviour is urgent, and therefore the purpose of this study. Socio-economic position (SEP) and stress are known to affect many behaviours and outcomes, and were therefore focal points in the study. METHODS: In a cross-sectional survey study, we examined whether Socio-economic position (SEP) would amplify associations between heightened stress levels and self-reported negative-affect related reasons for snacking. Next, we investigated whether Socio-economic position (SEP) predicted frequency of snacking behaviour, and how stress and other reasons for snacking could explain this association. Outcome measures were reasons people indicated for snacking, and frequency of snacking behaviour. RESULTS: Analyses revealed that people seem to find more reasons to snack when they are stressed, and that this association was more pronounced for people with a high compared to low socio-economic position. Furthermore, a higher socio-economic position was associated with a higher frequency of snacking, and both snacking to reward oneself and snacking because of the opportunity to do so remained significant mediators. CONCLUSION: Whereas low socio-economic position was associated with higher stress levels, this did not translate into increased snacking. Contrarily, those with higher socio-economic position could be more prone to using 'reasons to snack', which may result in justification of unhealthy snacking behaviour.

Eating behavior and food purchases during the COVID-19 lockdown: A cross-sectional study among adults in the Netherlands.

On March 15, 2020, the Dutch Government implemented COVID-19 lockdown measures. Although self-quarantine and social-distancing measures were implemented, restrictions were less severe compared to several other countries. The aim of this study was to assess changes in eating behavior and food purchases among a representative adult sample in the Netherlands (n = 1030), five weeks into lockdown. The results show that most participants did not change their eating behaviors (83.0%) or food purchases (73.3%). However, socio-demographic differences were observed among those that reported changes during lockdown. For example, participants with overweight (OR = 2.26, 95%CI = 1.24-4.11) and obesity (OR = 4.21, 95%CI = 2.13-8.32) were more likely to indicate to eat unhealthier during lockdown compared to participants with a healthy weight. Those with a high educational level (OR = 2.25, 95%-CI = 1.03-4.93) were also more likely to indicate to eat unhealthier during lockdown compared to those with a low educational level. Older participants were more likely to indicate to experience no differences in their eating behaviors compared to those of younger age, who were more likely to indicate that they ate healthier (OR = 1.03, 95%CI = 1.01-1.04) as well as unhealthier (OR = 1.04, 95%CI = 1.02-1.06) during lockdown. Participants with obesity were more likely to indicate to purchase more chips/snacks (OR = 2.79, 95%CI = 1.43-5.45) and more nonalcoholic beverages (OR = 2.74, 95%CI = 1.36-5.50) during lockdown in comparison with those with a healthy weight. Of those that used meal delivery services before, 174 (29.5%) indicated to use meal delivery services more frequently during lockdown. Although the results confirm the persistence of dietary routines, profound socio-demographic differences were observed for those that did report changes. Especially for individuals with overweight and obesity, the lockdown has taken its toll on healthy dietary choices. Further research should unravel underlying mechanisms for these observations.

Snacks and The City: Unexpected Low Sales of an Easy-Access, Tasty, and Healthy Snack at an Urban Snacking Hotspot.

: While many people declare an intention to eat and snack more healthily, a large body of research has found that these intentions often do not translate into actual behavior. This failure to fulfil intentions is regularly attributed to the obesogenic environment, on which basis it is assumed that changing the food environment may lead to more healthy snacking behavior. To test this premise in real life practice, the present research project investigated whether making a healthy snack easy-to-access in an urban environment characterized by unhealthy snacking would support people in their intentions of purchasing more healthy snacks. The urban snack project consisted of three phases. In Phase 1, a hotspot location for unhealthy snacking was determined by using a Global Positioning System to track people's snacking locations anda survey to verify the location . In Phase 2, an attractive snack was developed that met consumers' criteria of what constituted a healthy and tasty snack, together with corresponding branding that also included a small food truck from which to sell the newly developed snacks. In Phase 3, the snack was sold from the food truck located at the previously determined unhealthy snacking hotspot. We counted the number of snacks sold and canvassed people's opinions about the snack and its branding, finding that in spite of people's appreciation for the snack, the food truck, and the branding, actual sales of the snack were very low. In the Discussion, we name predominant eating and purchasing habits as possible reasons for these low sales. Future research could focus on placing the healthy snack directly beside people's habitual snack purchase location to ensure that the new choice gets better recognized. Overall, the findings suggest that merely placing healthy snacks more prominently in people's food environment is not sufficient to lead people to snack more healthily.

The snack that has it all: People's associations with ideal snacks.

Although many people intend to eat healthily, their actual snacking behavior is often marked by a high consumption of calorie-dense, unhealthy snacks. One reason for this discrepancy may be that people tend to associate unhealthy food with tasty food, preventing them to follow up on their healthy snacking goals. To support people in snacking more healthily according to their intentions, there is an urgent need to better understand how people perceive the 'ideal snack', which may eventually be used to make healthy snacks more attractive. In the present research, we aim to elucidate conceptions of ideal snacks without loaded connotations of healthy and unhealthy, and subsequently compare them to features that are associated with healthy and unhealthy snacks. A Dutch community sample (N = 1087) was asked to generate conceptions of their ideal snack, and name features of what they considered to be (un)healthy snacks. The results revealed a multitude of idiosyncratic ideal snack conceptions. Commonalities were sensory characteristics and the notion of 'healthy'. Healthy and unhealthy snacks were primarily associated with their positive or negative consequences for health. These findings may inform the design and marketing of healthy, nutritionally balanced snacks that are palatable and attractive to the very people that make food choices.

Preoccupied with the body: mild stress amplifies the relation between rumination and interoception.

Classic and modern emotion theories suggest that the perception of bodily sensations, or interoception, is foundational to emotion processing. The present research examined whether interoception is enhanced among people high in ruminative tendencies, especially under stress. To test this notion, the present research examined the effects of a mild stressor on subjective and objective measures of interoception among people varying in ruminative tendencies. Under conditions of mild stress, rumination was positively associated with self-reported private body consciousness -a marker of interoceptive sensibility- in Study 1 (N = 312) and with heartbeat detection accuracy (especially in the presence of auditory interference) in Study 2 (N = 180). In both studies, rumination was not significantly associated with interoceptive sensibility or accuracy in the absence of stress. These findings suggest that stress-induced amplification of bodily sensations may be important in explaining emotional dysregulation among chronic ruminators.

Becoming who you are: An integrative review of self-determination theory and personality systems interactions theory.

One of the enduring missions of personality science is to unravel what it takes to become a fully functioning person. In the present article, the authors address this matter from the perspectives of self-determination theory (SDT) and personality systems interactions (PSI) theory. SDT (a) is rooted in humanistic psychology; (b) has emphasized a first-person perspective on motivation and personality; (c) posits that the person, supported by the social environment, naturally moves toward growth through the satisfaction of basic psychological needs for autonomy, competence, and relatedness. PSI theory (a) is rooted in German volition psychology; (b) has emphasized a third-person perspective on motivation and personality; and (c) posits that a fully functioning person can form and enact difficult intentions and integrate new experiences, and that such competencies are facilitated by affect regulation. The authors review empirical support for SDT and PSI theory, their convergences and divergences, and how the theories bear on recent empirical research on internalization, vitality, and achievement flow. The authors conclude that SDT and PSI theory offer complementary insights into developing a person's full potential.

Self-restraint spillover: Inhibitory control disrupts appetite regulation among ruminators.

OBJECTIVE: People can use inhibitory control to temporarily inhibit their personal preferences to achieve their long-term goals. According to the ego fixation model (Koole et al., 2014), ruminators have difficulties relaxing inhibitory control, leading them to continue inhibiting their personal needs, even when this is no longer required by the situation. Inhibitory control may thus disrupt healthy appetite regulation among ruminators. METHOD: Among 324 Dutch undergraduate students (218 women; Mage = 21.5), different inhibitory control states were manipulated by varying whether or not participants exerted inhibitory control (Study 1) or priming high versus low inhibitory control (Study 2). All participants then performed a food-tasting task. Healthy appetite regulation was defined as a positive correlation between level of food deprivation and preference for high-calorie foods. RESULTS: For taste ratings, the interaction between inhibitory control and rumination was significant in each study: Inhibitory control disrupted healthy appetite regulation in taste preferences among ruminators, but not among non-ruminators. For eating behavior, the same interaction effect was significant when the two studies were combined. CONCLUSIONS: Inhibitory control disrupts healthy appetite regulation among ruminators. These findings suggest the need for caution in interventions that rely on inhibitory control, especially among samples with compulsive thought tendencies.