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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BACKGROUND: It is generally unknown to what extent organ transplant recipients can be physically challenged. During an expedition to Mount Kilimanjaro, the tolerance for strenuous physical activity and high-altitude of organ transplant recipients after various types of transplantation was compared to non-transplanted controls.METHODS: Twelve organ transplant recipients were selected to participate (2 heart-, 2 lung-, 2 kidney-, 4 liver-, 1 allogeneic stem cell- and 1 small bowel-transplantation). Controls comprised the members of the medical team and accompanying family members (n = 14). During the climb, cardiopulmonary parameters and symptoms of acute mountain sickness were recorded twice daily. Capillary blood analyses were performed three times during the climb and once following return.RESULTS: Eleven of the transplant participants and all controls began the final ascent from 4700 meters and reached over 5000 meters. Eight transplant participants (73%) and thirteen controls (93%) reached the summit (5895m). Cardiopulmonary parameters and altitude sickness scores demonstrated no differences between transplant participants and controls. Signs of hyperventilation were more pronounced in transplant participants and adaptation to high-altitude was less effective, which was related to a decreased renal function. This resulted in reduced metabolic compensation.CONCLUSION: Overall, tolerance to strenuous physical activity and feasibility of a high-altitude expedition in carefully selected organ transplant recipients is comparable to non-transplanted controls.
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Background: Short-term survival after solid-organ transplantation has substantially improved, and the focus has shifted to long-term survival, including the role of physical activity (PA). Knowledge about PA and sedentary time in recipients of solid-organ transplantation is limited, and identification of the levels and associated factors is necessary for intervention development.Objective: The objectives of this study were to investigate the level of PA and sedentary time in recipients of solid-organ transplantation and to identify factors associated with these behaviors.Design: The design consisted of a cross-sectional survey.Methods: Questionnaires on PA level, sedentary time, and potential associated factors were used for recipients of solid-organ transplantation (kidney, liver, lung, and heart [N = 656]). Multiple regression analyses with a variable selection procedure were used.Results: Fewer than 60% of the recipients fulfilled the PA guideline. Factors significantly associated with a lower level of PA included being a woman, younger age (nonlinear), not actively working or being retired, physical limitations, and low expectations and self-confidence. Factors significantly associated with less sedentary time included exercise self-efficacy and not actively working or being retired. Significantly associated with more sedentary time were a high education level, fear of negative effects, physical limitations, and the motivator "health and physical outcomes." The type of transplantation did not significantly influence either of the outcome measures.Limitations: The design did not allow for causal inferences to be made. The studied associated factors were limited to individual and interpersonal factors. Self-reported measures of PA and sedentary time were used.Conclusions: In intervention development directed at increasing the level of PA and reducing sedentary time in recipients of solid-organ transplantation, attention should be paid to physical limitations, fear of negative effects, low expectations and self-confidence, health and physical outcomes, and exercise self-efficacy.
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The SPRONG group, originating from the CoE KennisDC Logistiek, focuses on 'Low Impact in Lastmile Logistics' (LILS). The LILS group conducts practical research with local living labs and learning communities. There is potential for more collaboration and synergy for nationwide scaling of innovations, which is currently underutilized. LILS aims to make urban logistics more sustainable and facilitate necessary societal transitions. This involves expanding the monodisciplinary and regional scope of CoE KennisDC Logistiek to a multidisciplinary and supra-regional approach, incorporating expertise in spatial planning, mobility, data, circularity, AI, behavior, and energy. The research themes are:- Solutions in scarce space aiming for zero impact;- Influencing behavior of purchasers, recipients, and consumers;- Opportunities through digitalization.LILS seeks to increase its impact through research and education beyond its regions. Collaboration between BUas, HAN, HR, and HvA creates more critical mass. LILS activities are structured around four pillars:- Developing a joint research and innovation program in a roadmap;- Further integrating various knowledge domains on the research themes;- Deepening methodological approaches, enhancing collaboration between universities and partners in projects, and innovating education (LILS knowledge hub);- Establishing an organizational excellence program to improve research professionalism and quality.These pillars form the basis for initiating and executing challenging, externally funded multidisciplinary research projects. LILS is well-positioned in regions where innovations are implemented and has a strong national and international network and proven research experience.Societal issue:Last-mile logistics is crucial due to its visibility, small deliveries, high costs, and significant impact on emissions, traffic safety, and labor hours. Lastmile activities are predicted to grow a 20% growth in the next decade. Key drivers for change include climate agreements and energy transitions, urban planning focusing on livability, and evolving retail landscapes and consumer behavior. Solutions involve integrating logistics with spatial planning, influencing purchasing behavior, and leveraging digitalization for better data integration and communication. Digital twins and the Physical Internet concept can enhance efficiency through open systems, data sharing, asset sharing, standardization, collaboration protocols, and modular load units.Key partners: Buas, HR, HAN, HvAPartners: TNO, TU Delft, Gemeente Rotterdam, Hoger Onderwijs Drechtsteden, Significance, Metropolitan Hub System, evofenedex, Provincie Gelderland, Duurzaam Bereikbaar Heijendaal, Gemeente Alphen aan den Rijn, Radboud Universiteit, I&W - DMI, DHL, TLN, Noorderpoort, Fabrications, VUB, Smartwayz, RUG, Groene Metropoolregio.