Successful organizational change requires substantial efforts from both the leaders and recipients of change. After a long tradition of focusing on change leaders, academics now increasingly focus on the role of change recipients. The current literature on recipients, however, offers mostly binary categorizations of their roles in change (e.g., supportive vs. unsupportive) obtained from questionnaires. Such an approach does not reveal how events can cause shifts in recipients’ role taking during a change initiative. Actors’ roles change and are changed by change events. We adopted an assisted sensemaking approach using a narrative methodology to study recipients’ various storylines by which they construct and reconstruct their own multiple roles throughout change. Eighty participants were asked to tell the retrospective story of their experience of, and role taking in, a top-down change initiative as if they were crafting chapters of a book. Analysis and classification of these individual stories yielded five underlying composite narratives, each representing typical shifts in perceived role taking by recipients during a change initiative. This study highlights and illustrates how recipients’ role taking is a complex, adaptive, and social process.
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The inefficiency of maintaining static and long-lasting safety zones in environments where actual risks are limited is likely to increase in the coming decades, as autonomous systems become more common and human workers fewer in numbers. Nevertheless, an uncompromising approach to safety remains paramount, requiring the introduction of novel methods that are simultaneously more flexible and capable of delivering the same level of protection against potentially hazardous situations. We present such a method to create dynamic safety zones, the boundaries of which can be redrawn in real-time, taking into account explicit positioning data when available and using conservative extrapolation from last known location when information is missing or unreliable. Simulation and statistical methods were used to investigate performance gains compared to static safety zones. The use of a more advanced probabilistic framework to further improve flexibility is also discussed, although its implementation would not offer the same level of protection and is currently not recommended.
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Background: The dynamics of maternal and newborn care challenge midwifery education programs to keep up-to-date. To prepare for their professional role in a changing world, role models are important agents for student learning. Objective: To explore the ways in which Dutch and Icelandic midwifery students identify role models in contemporary midwifery education. Methods: We conducted a descriptive, qualitative study between August 2017 and October 2018. In the Netherlands, 27 students participated in four focus groups and a further eight in individual interviews. In Iceland, five students participated in one focus group and a further four in individual interviews. All students had clinical experience in primary care and hospital. Data were analyzed using inductive content analysis. Results: During their education, midwifery students identify people with attitudes and behaviors they appreciate. Students assimilate these attitudes and behaviors into a role model that represents their ‘ideal midwife’, who they can aspire to during their education. Positive role models portrayed woman-centered care, while students identified that negative role models displayed behaviors not fitting with good care. Students emphasized that they learnt not only by doing, they found storytelling and observing important aspects of role modelling. Students acknowledged the impact of positive midwifery role models on their trust in physiological childbirth and future style of practice. Conclusion: Role models contribute to the development of students’ skills, attitudes, behaviors, identity as midwife and trust in physiological childbirth. More explicit and critical attention to how and what students learn from role models can enrich the education program.
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This study focuses on SME networks of design and high-tech companies in Southeast Netherland. By highlighting the personal networks of members across design and high-tech industries, the study attempts to identify the main brokers in this dynamic environment. In addition, we investigate whether specific characteristics are associated with these brokers. The main contribution of the paper lies in the fact that, in contrast to most other work, it is quantitative and that it focuses on brokers identified in an actual network (based on both suppliers and users of the knowledge infrastructure). Studying the phenomenon of brokerage provides us with clear insights into the concept of brokerage regarding SME networks in different fields. In particular we highlight how third parties contribute to the transfer and development of knowledge. Empirical results show, among others that the most influential brokers are found in the nonprofit and science sector and have a long track record in their branch.
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Background The plantar intrinsic foot muscles (PIFMs) have a role in dynamic functions, such as balance and propulsion, which are vital to walking. These muscles atrophy in older adults and therefore this population, which is at high risk to falling, may benefit from strengthening these muscles in order to improve or retain their gait performance. Therefore, the aim was to provide insight in the evidence for the effect of interventions anticipated to improve PIFM strength on dynamic balance control and foot function during gait in adults. Methods A systematic literature search was performed in five electronic databases. The eligibility of peer-reviewed papers, published between January 1, 2010 and July 8, 2020, reporting controlled trials and pre-post interventional studies was assessed by two reviewers independently. Results from moderate- and high-quality studies were extracted for data synthesis by summarizing the standardized mean differences (SMD). The GRADE approach was used to assess the certainty of evidence. Results Screening of 9199 records resulted in the inclusion of 11 articles of which five were included for data synthesis. Included studies were mainly performed in younger populations. Low-certainty evidence revealed the beneficial effect of PIFM strengthening exercises on vertical ground reaction force (SMD: − 0.31-0.37). Very low-certainty evidence showed that PIFM strength training improved the performance on dynamic balance testing (SMD: 0.41–1.43). There was no evidence for the effect of PIFM strengthening exercises on medial longitudinal foot arch kinematics. Conclusions This review revealed at best low-certainty evidence that PIFM strengthening exercises improve foot function during gait and very low-certainty evidence for its favorable effect on dynamic balance control. There is a need for high-quality studies that aim to investigate the effect of functional PIFM strengthening exercises in large samples of older adults. The outcome measures should be related to both fall risk and the role of the PIFMs such as propulsive forces and balance during locomotion in addition to PIFM strength measures.
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Long-term care facilities are currently installing dynamic lighting systems with the aim to improve the well-being and behaviour of residents with dementia. The aim of this study was to investigate the implementation of dynamic lighting systems from the perspective of stakeholders and the performance of the technology. Therefore, a questionnaire survey was conducted with the management and care professionals of six care facilities. Moreover, light measurements were conducted in order to describe the exposure of residents to lighting. The results showed that the main reason for purchasing dynamic lighting systems lied in the assumption that the well-being and day/night rhythmicity of residents could be improved. The majority of care professionals were not aware of the reasons why dynamic lighting systems were installed. Despite positive subjective ratings of the dynamic lighting systems, no data were collected by the organizations to evaluate the effectiveness of the lighting. Although the care professionals stated that they did not see any large positive effects of the dynamic lighting systems on the residents and their own work situation, the majority appreciated the dynamic lighting systems more than the old situation. The light values measured in the care facilities did not exceed the minimum threshold values reported in the literature. Therefore, it seems illogical that the dynamic lighting systems installed in the researched care facilities will have any positive health effects.
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This paper describes a research about the changing role and competences of teachers and the willingness of the teachers to change. The researchers developed and conducted a survey at Fontys University of Applied Sciences department engineering to find out how teachers teach and how they would want to teach. The conclusion drawn from this research results in five subjects of attention: 1 To investigate new teaching competences 2 To investigate new teaching strategies 3 To develop collaborating professional environments for teachers 4 To develop a formal declaration of how companies can participate effectively in the process of the transition of youngsters to professional practitioners 5 To investigate how the organization should change their culture and structure towards a professional learning environment for students and teachers. The above mentioned items will be subject of further research in the coming study year. The main goal is to develop a business case or strategic plan on how to implement change in teaching engineering education.
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Financial constraints and risk taking are two well-established determinants of firm performance, however, no research analyzes how these variables are connected in the context of a high risk environment. Using data from microfinance clients in Tanzania, we derive a novel financial constraints measure and incorporate a psychometric risk taking scale. Results confirm the importance of access to finance and risk attitudes for business development. Also, we provide preliminary evidence for an interaction between financial constraints and risk taking. Financial constraints “throw sand in the wheels” and protect risk taking entrepreneurs from the negative impact of risk taking on microenterprise performance.
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There is emerging evidence that the performance of risk assessment instruments is weaker when used for clinical decision‐making than for research purposes. For instance, research has found lower agreement between evaluators when the risk assessments are conducted during routine practice. We examined the field interrater reliability of the Short‐Term Assessment of Risk and Treatability: Adolescent Version (START:AV). Clinicians in a Dutch secure youth care facility completed START:AV assessments as part of the treatment routine. Consistent with previous literature, interrater reliability of the items and total scores was lower than previously reported in non‐field studies. Nevertheless, moderate to good interrater reliability was found for final risk judgments on most adverse outcomes. Field studies provide insights into the actual performance of structured risk assessment in real‐world settings, exposing factors that affect reliability. This information is relevant for those who wish to implement structured risk assessment with a level of reliability that is defensible considering the high stakes.
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Abstract Background: Nurses are consistently present throughout the rehabilitation of older patients but are apprehensive about performing goal-centred care in the multidisciplinary team. Objectives: The aim of this review was to explore working interventions on setting goals and working with goals designed for nurses in geriatric rehabilitation, and to describe their distinctive features. Methods: We performed a scoping review. We searched MEDLINE and CINAHL through August 4, 2021. Search terms related to the following themes: nurses, rehabilitation, geriatric, goal and method. We used snowballing to find additional. From the selected studies, we systematically extracted data on means, materials and the nursing role and summarized them in a narrative synthesis, using intervention component analysis. Results: The study includes 13 articles, describing 11 interventions which were developed for six different aims: improving multidisciplinary team care; increasing patient centredness; improving disease management by patients; improving the psychological, and emotional rehabilitation; increasing the nursing involvement in rehabilitation; or helping patients to achieve goals. The interventions appeal to four aspects of the nursing profession: assessing self-care skills incorporating patient's preferences; setting goals with patients, taking into account personal needs and what is medically advisable; linking the needs of the patient with multidisciplinary professional treatment and vice versa; and thus, playing an intermediate role and supporting goal achievement. Conclusions: The interventions show that in goal-centred care, the nurse might play an important unifying role between patients and the multidisciplinary team. With the support of nurses, the patient may become more aware of the rehabilitation process and transfer of ownership of treatment goals from the multidisciplinary team to the patient might be achieved. Not many interventions were found meant to support thenursing role. This may indicate a blind spot in the rehabilitation community to the additional value of its contribution.
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