IntroductionThe driving pressure (ΔP) has an independent association with outcome in patients with acute respiratory distress syndrome (ARDS). INTELLiVENT-Adaptive Support Ventilation (ASV) is a closed-loop mode of ventilation that targets the lowest work and force of breathing.AimTo compare transpulmonary and respiratory system ΔP between closed-loop ventilation and conventional pressure controlled ventilation in patients with moderate-to-severe ARDS.MethodsSingle-center randomized cross-over clinical trial in patients in the early phase of ARDS. Patients were randomly assigned to start with a 4-h period of closed-loop ventilation or conventional ventilation, after which the alternate ventilation mode was selected. The primary outcome was the transpulmonary ΔP; secondary outcomes included respiratory system ΔP, and other key parameters of ventilation.ResultsThirteen patients were included, and all had fully analyzable data sets. Compared to conventional ventilation, with closed-loop ventilation the median transpulmonary ΔP with was lower (7.0 [5.0–10.0] vs. 10.0 [8.0–11.0] cmH2O, mean difference − 2.5 [95% CI − 2.6 to − 2.1] cmH2O; P = 0.0001). Inspiratory transpulmonary pressure and the respiratory rate were also lower. Tidal volume, however, was higher with closed-loop ventilation, but stayed below generally accepted safety cutoffs in the majority of patients.ConclusionsIn this small physiological study, when compared to conventional pressure controlled ventilation INTELLiVENT-ASV reduced the transpulmonary ΔP in patients in the early phase of moderate-to-severe ARDS. This closed-loop ventilation mode also led to a lower inspiratory transpulmonary pressure and a lower respiratory rate, thereby reducing the intensity of ventilation.Trial registration Clinicaltrials.gov, NCT03211494, July 7, 2017. https://clinicaltrials.gov/ct2/show/NCT03211494?term=airdrop&draw=2&rank=1.
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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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The hospitality industry contributes significantly to global climate change through its high resource consumption and emissions due to travel. As public pressure for hotels to develop sustainability initiatives to mitigate their footprint grows, a lack of understanding of green behavior and consumption of hotel guests hinders the adoption of effective programs. Most tourism research thus far has focused on the ecotourism segment, rather than the general population of travelers, and while research in consumer behavior shows that locus of control (LOC) and guilt can influence guests’ environmental behavior, those factors have not been tested with consideration of the subjective norm to measure their interaction and effect on recycling behavior. This study first examines the importance of internal and external LOC on factors for selecting hotel accommodation and the extent of agreement about hotel practices and, second, examines the differences in recycling behavior among guests with internal versus external LOC under levels of positive versus negative subjective norms and feelings of low versus high guilt.
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Client: Foundation Innovation Alliance (SIA - Stichting Innovatie Alliantie) with funding from the ministry of Education, Culture and Science (OCW) Funder: RAAK (Regional Attention and Action for Knowledge circulation) The RAAK scheme is managed by the Foundation Innovation Alliance (SIA - Stichting Innovatie Alliantie) with funding from the ministry of Education, Culture and Science (OCW). Early 2013 the Centre for Sustainable Tourism and Transport started work on the RAAK-MKB project ‘Carbon management for tour operators’ (CARMATOP). Besides NHTV, eleven Dutch SME tour operators, ANVR, HZ University of Applied Sciences, Climate Neutral Group and ECEAT initially joined this 2-year project. The consortium was later extended with IT-partner iBuildings and five more tour operators. The project goal of CARMATOP was to develop and test new knowledge about the measurement of tour package carbon footprints and translate this into a simple application which allows tour operators to integrate carbon management into their daily operations. By doing this Dutch tour operators are international frontrunners.Why address the carbon footprint of tour packages?Global tourism contribution to man-made CO2 emissions is around 5%, and all scenarios point towards rapid growth of tourism emissions, whereas a reverse development is required in order to prevent climate change exceeding ‘acceptable’ boundaries. Tour packages have a high long-haul and aviation content, and the increase of this type of travel is a major factor in tourism emission growth. Dutch tour operators recognise their responsibility, and feel the need to engage in carbon management.What is Carbon management?Carbon management is the strategic management of emissions in one’s business. This is becoming more important for businesses, also in tourism, because of several economical, societal and political developments. For tour operators some of the most important factors asking for action are increasing energy costs, international aviation policy, pressure from society to become greener, increasing demand for green trips, and the wish to obtain a green image and become a frontrunner among consumers and colleagues in doing so.NetworkProject management was in the hands of the Centre for Sustainable Tourism and Transport (CSTT) of NHTV Breda University of Applied Sciences. CSTT has 10 years’ experience in measuring tourism emissions and developing strategies to mitigate emissions, and enjoys an international reputation in this field. The ICT Associate Professorship of HZ University of Applied Sciences has longstanding expertise in linking varying databases of different organisations. Its key role in CARMATOP was to create the semantic wiki for the carbon calculator, which links touroperator input with all necessary databases on carbon emissions. Web developer ibuildings created the Graphical User Interface; the front end of the semantic wiki. ANVR, the Dutch Association of Travel Agents and Tour operators, represents 180 tour operators and 1500 retail agencies in the Netherlands, and requires all its members to meet a minimum of sustainable practices through a number of criteria. ANVR’s role was in dissemination, networking and ensuring CARMATOP products will last. Climate Neutral Group’s experience with sustainable entrepreneurship and knowledge about carbon footprint (mitigation), and ECEAT’s broad sustainable tourism network, provided further essential inputs for CARMATOP. Finally, most of the eleven tour operators are sustainable tourism frontrunners in the Netherlands, and are the driving forces behind this project.
The latest IPCC Report (2022) provided by the UN shows us that, to guarantee a safe future for upcoming generations, we must change how we lead our lives on several levels. However, the increasing urgency to act and behave in a way that is not damaging the climate is bringing many psychological concerns to young generations. Worldwide reports are demonstrating how the issue of eco-anxiety is increasing daily, and how young people are feeling more hopeless than ever. Climate change has become a climate crisis, and individuals are experiencing pressure and fear incessantly (Marks et al., 2021). We, as Climate Streamers, have often found ourselves in this situation as well, but rather than freezing, we decided to take this challenge and think of solutions. Therefore, with the support of Breda University of Applied Sciences, the Performatory community, the BUas Startup Support Team, and outside mentors, we created Climate Streamers Foundation: a new youth-led non-profit organisation and a movement working towards a more inclusive and less polarised climate action. By working with leisure elements and a positive and appreciative approach, we want to give back hope, voice and power to the youth and inspire each other genuinely and sustainably. The purpose of this application is to allow us to elaborate a feasibility study concerning our MVP (minimum viable product), the card game, and boost the overall concept. We intend to implement the researched data to improve the design and sales management. The card game aims to stimulate appreciative conversations by giving space to players to express their opinions and personal stories and it is designed so everyone can play it, regardless of background and knowledge. After giving 200 games in production, we launched the card game in July 2022.
Despite Dutch Hospitality industry’s significant economic value, employers struggle to attract and retain early career professionals at a time when tourism is forecasted to grow exponentially (Ruël, 2018). Universally, hospitality management graduates are shunning hospitality careers preferring other career paths; stimulating the Dutch Hospitality to find innovative ways of attracting and retaining early career professionals. Following calls from the Human Resource Management (HRM) community (Ehnert, 2009), we attribute this trend to personnel being depicted as rentable resources, driving profit’’ often at personal expense. For example, hotels primarily employ immigrants and students for a minimum wage suppressing salaries of local talent (Kusluvan, et al 2010, O’Relly and Pfeffer, 2010). Similarly, flattening organizational structures have eliminated management positions, placing responsibility on inexperienced shoulders, with vacancies commonly filled by pressured employees accepting unpaid overtime jeopardizing their work life balance (Davidson, et al 2010,). These HRM practices fuel attrition by exposing early career professionals to burnout (Baum et al, 2016, Goh et al, 2015, Deery and Jog, 2009). Collectively this has eroded the industry’s employer brand, now characterized by unsocial working hours, poor compensation, limited career opportunities, low professional standing, high turnover and substance abuse (Mooney et al, 2016, Gehrels and de Looij, 2011). In contrast, Sustainable HRM “enables an organizational goal achievement while simultaneously reproducing the human resource base over a long-lasting calendar time (Ehnert, 2009, p. 74).” Hence, to overcome this barrier we suggest embracing the ROC framework (Prins et al, 2014), which (R)espects internal stakeholders, embraces an (O)pen HRM approach while ensuring (C)ontinuity of economic and societal sustainability which could overcome this barrier. Accordingly, we will employ field research, narrative discourse, survey analysis and quarterly workshops with industry partners, employees, union representatives, hotel school students to develop sustainable HRM practices attracting and retaining career professionals to pursue Dutch hospitality careers.