The literature on how organizations respond to institutional pressure has shown that the individual decision-makers’ interpretation of institutional pressure played an important role in developing organizational responses. However, it has paid less attention to how this interpretation ultimately contributes to their range of organizational decisions when responding to the same institutional pressure. We address this gap by interviewing board members of U.S. and Dutch hospitals involved in adopting best practices regarding board evaluation. We found four qualitatively different cognitive frames that board members relied on to interpret institutional pressure, and which shaped their organizational response. We contribute to the literature on organizational response to institutional pressure by empirically investigating how decision-makers interpret institutional pressure, by suggesting prior experience and role definition as moderating factors of multidimensional cognitive frames, and by showing how these cognitive frames influence board members’ response to the same institutional pressure.
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Introduction: Pressure ulcers are a high cost, high volume issue for health and medical care providers, affecting patients’ recovery and psychological wellbeing. The current research of support surfaces on pressure as a risk factor in the development of pressure ulcers is not relevant to the specialised, controlled environment of the radiological setting. Method: 38 healthy participants aged 19-51 were placed supine on two different imaging surfaces. The XSENSOR pressure mapping system was used to measure the interface pressure. Data was acquired over a time of 20 minutes preceded by 6 minutes settling time to reduce measurement error. Qualitative information regarding participants’ opinion on pain and comfort was recorded using a questionnaire. Data analysis was performed using SPSS 22. Results: Data was collected from 30 participants aged 19 to 51 (mean 25.77, SD 7.72), BMI from 18.7 to 33.6 (mean 24.12, SD 3.29), for two surfaces, following eight participant exclusions due to technical faults. Total average pressure, average pressure for jeopardy areas (head, sacrum & heels) and peak pressure for jeopardy areas were calculated as interface pressure in mmHg. Qualitative data showed that a significant difference in experiences of comfort and pain was found in the jeopardy areas (P<0.05) between the two surfaces. Conclusion: A significant difference is seen in average pressure between the two surfaces. Pain and comfort data also show a significant difference between the surfaces, both findings support the proposal for further investigation into the effects of radiological surfaces as a risk factor for the formation of pressure ulcers.
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Objective. In this study an experimental set-up for measuring skin microvascular responses of the footsole to changes in externally applied pressure was analysed. Design. A clinical study. Skin microvascular blood flow was measured in healthy volunteers, during and after external mechanical pressure of different magnitudes. Background. During standing and walking the footsole is commonly exposed to high static and dynamic mechanical pressure, resulting in changes in the microcirculation of the footsole. In diabetic patients a disturbed interaction between externally applied pressure and skin microvascular response seems to be involved in the development of a foot ulcer. Methods. Eleven volunteers participated in the study. Static loads were applied to the heel part of the footsole with the person in a supine position. Contact pressure and skin blood flux, based on the laser Doppler technique, were simultaneously monitored. The pressure used was varied in five discrete steps between 10 and 160 kPa and applied during a period of 5 min each. The microcirculation was measured during as well as after pressure loading. Results. Pressures of 40 kPa and higher do stop the blood flow in the skin micro-circulation. Releasing the applied pressure resulted in a hyperaemic response. This response appears to increase in amplitude at increasing pressures up to 800% of the baseline laser Doppler fluxmetry level. Beyond a pressure level of 80 kPa the hyperaemic response seems not to be influenced by the pressure level. The time needed to achieve the maximal laser Doppler fluxmetry level decreased when the pressure was raised from 10 to 80 kPa, but increased again when higher pressures were applied (P = 0.051). An intra-individual variation of 11-50% was observed for the parameters describing the blood flux before, during, and after pressure application. Conclusion. Simultaneously measuring changes in contact pressure and laser Doppler flux of the footsole is a useful method to study the interaction of external mechanical pressure and skin microvascular reactions. Pressures above 40 kPa stop skin microvascular blood flow. Releasing the applied pressure results in a hyperaemic response, which increases when the applied pressure increases from 40 to 80 kPa. Higher pressures do not influence the amplitude in skin microvascular response, but result in a longer delay to maximal hyperaemia.
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MSEs have encountered limitations while pushing the limits of catheter tip sensors performance. The limitations summarized: - sensors are not immune to electrical signal noise, cross talk, and EM fields; - sensors are not immune to high magnetic fields, i.e. not suitable for MR imaging; - extending the amount of sensors on the catheter tip is limited due to cluttering of wires. A fundamentally different approach using integrated optics is chosen for developing a new generation catheter sensors. The complexity of the design and production problems represents a knowledge gap, that can be bridged in the proposed consortium. This project consists of four work packages, total duration two years, subdivided into four phases. A crucial deliverable of the project is presented at the end of phase IV (WP4), namely a demonstrator integrating pressure and temperature sensors (obtained from WP1) with a newly designed readout system. This system is modularly extendable for future catheter tip sensors. In WP1, pressure- and temperature sensors are developed using two design approaches. In WP2 the influence of downscaling an ultrasound MZI device is explored and the microfabrication process parameters are studied. An additional goal of WP2 is to find the most suitable method for measuring lactate concentration. Among the deliverables five manuscripts: manuscript 1 includes simulations and measurements of the developed pressure and temperature sensors, manuscript 2 answers the question: can a grated fiber be used for measuring pressure and temperature on a tip? Manuscript 3 answers the question: which method is most suitable for measuring lactate concentration on a tip? Manuscript 4 answers the question: does a US intensity detector fit on a catheter tip while obeying the LoR? Manuscript 5 describes the performance of the demonstrator (Phase IV), i.e. integration of T/P sensing with a modular read out system.
This project is part of an interdisciplinary and international collaboration bringing together experts in nanomaterials, sensor technology, and engineering from the University of Technology of Troyes (UTT, France), Eindhoven University of Technology (TU/e, The Netherlands) and Hanze University of Applied Sciences (HUAS, The Netherlands). It presents an innovative, integrated approach including design, fabrication, characterization, and integration of flexible sensors dedicated to wind turbine blade monitoring, aiming to advance smart monitoring and renewable energy research. The sensor will be developed using functional polymer films decorated with conductive nanoparticles. A novel manufacturing approach will be applied, combining additive manufacturing techniques with the colloidal deposition of silver or gold nanoparticles.
