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Objective To assess upper airway volume changes after rapid maxillary expansion (RME) with three different expanders. Trial design Three-arm parallel randomized clinical trial. Methods Sixty-six patients, 10–16 years old, in permanent dentition, with maxillary transverse deficiency were recruited and assigned with block randomization (1:1:1 ratio) and allocation concealment to three groups of 22 patients each (Hyrax, Hybrid-Hyrax, and Keles keyless expander). The primary outcome (overall upper airway volume change) and secondary outcomes (volume changes in the nasal cavity, nasopharynx, oropharynx, and hypopharynx) were blindly assessed on the initial (T0) and final (T1, 6 months at appliance removal) cone beam computed tomography. Differences across groups were assessed with crude or adjusted for confounders (gender, age, growth stage, skeletal pattern, baseline airway volume, and amount of expansion) linear regression models. Results Fifty-one patients were analysed (19, 19, and 13 in the Hyrax, Hybrid-Hyrax, and Keles groups). Maxillary expansion resulted in considerable increases in total airway volume in the Hybrid-Hyrax group (+5902.1 mm3) and less in the Hyrax group (+2537.9 mm3) or the Keles group (+3001.4 mm3). However, treatment-induced changes for the primary and all secondary outcomes were of small magnitude and no significant difference was seen among the three expanderes in the total airway volume in either crude or adjusted analyses (P > 0.05 in all instances). Finally, among pre-peak patients (CVM 1–3), the Hybrid-Hyrax expander was associated with significantly greater increases in total airway volume compared to the Hyrax expander (P = 0.02). Conclusions RME resulted in relatively small increases in total upper airway volume and its separate compartments, with mostly no statistically significant differences across the Hyrax, Hybrid-Hyrax, and Keles groups. Limitations Significantly greater attrition was found in the Keles group due to appliance failure. The current trial might possibly be under-powered to detect differences between groups, if such exist. Harms Keles expanders blocked during activations and required substitution for completion of treatment. Protocol The protocol was not published before trial commencement. Registration Australian and New Zealand Clinical Trial Registry (ACTRN12617001136392). [ABSTRACT FROM AUTHOR]

Purpose: The growing instability of the labor market will almost certainly result in more employees whose values misfit with their organization's. This paper draws from the exit-neglect-voice-loyalty model to examine a broader range of responses to misfit; explores sociopolitical resources as the mechanisms through which misfit transmits its effects and investigates job mobility as a boundary condition enhancing or constraining responses to misfit. Design/methodology/approach: A novel model (N = 152 New Zealand employees) examined links from misfit to two sociopolitical resources (perceived influence and organizational responsiveness) and from these to exit-neglect-voice-loyalty moderated by job mobility. Supplemental analyses examine moderated-mediation. Findings: Misfit negatively predicted both sociopolitical resources, perceived influence and organizational responsiveness. Moderated-mediation analyses showed that the constructive reactions to misfit (voice and loyalty) were predicted conditionally at low levels of job mobility and indirectly via the respective sociopolitical resources. In contrast, destructive reactions to misfit (exit and neglect) were predicted directly, with neglect predicted at high levels of job mobility. Research limitations/implications: Implications for human resource practitioners highlight the deleterious repercussions of misfit but also include the conditions under which misfit employees may attempt to constructively salvage their employment relationship. Originality/value: This study integrates a broader set of concurrent responses to misfit using the exit-neglect-voice-loyalty typology, as well as introducing sociopolitical perspectives to the literature on misfit. [ABSTRACT FROM AUTHOR]

Aims: To develop a comprehensive model of nursing turnover intention by examining the effects of job demands, job resources, personal demands and personal resources on burnout and work engagement and subsequently on the intention to leave the organization and profession. Background: The ageing population and a growing prevalence of multimorbidity are placing increasing strain on an ageing nursing workforce. Solutions that address the anticipated nursing shortage should focus on reducing burnout and enhancing the engagement of Registered Nurses (RNs) to improve retention. Design: A cross-sectional survey design. Method: Data were collected in 2014-2015 via an e-survey from 2,876 RNs working in New Zealand. Data were analysed with structural equation modelling. Results: Higher engagement results in lower intention to leave the organization and profession. Burnout has significant effects on intentions to leave through lower engagement. While most of the demands and resources' variables (except professional development) have effects on intentions to leave, greater workload and greater work-life interference result in higher burnout and are the strongest predictors of intentions to leave. Greater emotional demands (challenges) and greater selfefficacy also have strong effects in lowering intentions to leave through higher engagement. Conclusions: Employee burnout and work engagement play an important role in transmitting the impacts of job demands, job resources, personal demands and personal resources into RN intention to leave the organization and profession. Work-life interference and high workloads are major threats to nursing retention while challenge demands and higher levels of self-efficacy support better retention. [ABSTRACT FROM AUTHOR]

Background: Many registered nurses (RNs) increased their participation in the New Zealand health workforce during the Global Financial Crisis (GFC), resulting in low vacancy rates. However, based on the documented impact of improving economies, a mean RN age of about 50, and just-agreed substantive increases in RN pay rates, it is likely that many will soon leave or reduce the hours they work. This study aims to investigate whether improved financial security will encourage RNs to leave or reduce their work commitment and to identify the factors that influence such intentions., Methods: An exploratory study using a cross-sectional survey design. Data were collected in 2014-2015 via an e-survey of 2,910 RNs in New Zealand. Data were analysed by regression., Results: We found that due to "burnout" and low "work engagement", both of which are strongly affected by workload and work-life interference, 22.6% of the RNs surveyed plan to leave work altogether and a further 32% plan to reduce their workforce participation when their financial situations improve., Conclusions: The findings justify the urgent cooperative development, implementation and evaluation of a comprehensive suite of RN 'retention' measures involving national nursing organisations, the RN regulator and health system employers and funders.