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This multi-wave study uses the Transactional Model of Stress and Coping (TMSC) to investigate whether employees may view task changes as an organizational event that stimulates skill development or engenders job risks (i.e., qualitative job insecurity) and thereby affect employee job satisfaction. Additionally, drawing on Regulatory Focus Theory (RFT), the indirect effect of task changes on job satisfaction through these two mediators was theorized to depend on individual’s regulatory focus (i.e., prevention or promotion). Mediation effects from task changes to job satisfaction via skill development and qualitative job insecurity were tested at the within-person level, while the moderating role by regulatory focus at the between-person level was tested using cross-level interactions. Results supported most of our hypotheses and also offered some unexpected insights. Task changes increased perceptions of qualitative job insecurity, which subsequently decreased job satisfaction. Although task changes did not show a significant direct link with skill development, skill development did positively predict job satisfaction six months later. We found no moderated mediation effects, however our moderator directly influenced job insecurity and skill development. Overall, the current study contributes to science and practice by providing valuable insights into the stressful processes that can evolve from task changes. ispartof: European Journal Of Work And Organizational Psychology vol:32 issue:4 status: Published online

Background Patients with multiple rib fractures without a clinical flail chest are increasingly being treated with rib fixation; however, high-quality evidence to support this development is lacking. Methods We conducted a prospective multicenter observational study comparing rib fixation to non-operative treatment in all patients aged 18 years and older with computed tomography confirmed multiple rib fractures without a clinical flail chest. Three centers performed rib fixation as standard of care. For adequate comparison, the other three centers performed only non-operative treatment. As such clinical equipoise formed the basis for the comparison in this study. Patients were matched using propensity score matching. Results In total 927 patients with multiple rib fractures were included. In the three hospitals that performed rib fixation, 80 (14%) out of 591 patients underwent rib fixation. From the nonoperative centers, on average 71 patients were adequately matched to 71 rib fixation patients after propensity score matching. Rib fixation was associated with an increase in hospital length of stay (HLOS) of 4.9 days (95%CI 0.8–9.1, p = 0.02) and a decrease in quality of life (QoL) measured by the EQ5D questionnaire at 1 year of 0.1 (95% CI − 0.2–0.0, p = 0.035) compared to non-operative treatment. A subgroup analysis of patients who received operative care within 72 h showed a similar decrease in QoL. Up to 22 patients (28%) who underwent surgery experienced implant-related irritation. Conclusions We found no benefits and only detrimental effects associated with rib fixation. Based on these results, we do not recommend rib fixation as the standard of care for patients with multiple rib fractures. Trial registration Registered in the Netherlands Trial Register NTR6833 on 13/11/2017.

Patients with multiple rib fractures without a clinical flail chest are increasingly being treated with rib fixation; however, high-quality evidence to support this development is lacking.We conducted a prospective multicenter observational study comparing rib fixation to non-operative treatment in all patients aged 18 years and older with computed tomography confirmed multiple rib fractures without a clinical flail chest. Three centers performed rib fixation as standard of care. For adequate comparison, the other three centers performed only non-operative treatment. As such clinical equipoise formed the basis for the comparison in this study. Patients were matched using propensity score matching.In total 927 patients with multiple rib fractures were included. In the three hospitals that performed rib fixation, 80 (14%) out of 591 patients underwent rib fixation. From the nonoperative centers, on average 71 patients were adequately matched to 71 rib fixation patients after propensity score matching. Rib fixation was associated with an increase in hospital length of stay (HLOS) of 4.9 days (95%CI 0.8-9.1, p = 0.02) and a decrease in quality of life (QoL) measured by the EQ5D questionnaire at 1 year of 0.1 (95% CI - 0.2-0.0, p = 0.035) compared to non-operative treatment. A subgroup analysis of patients who received operative care within 72 h showed a similar decrease in QoL. Up to 22 patients (28%) who underwent surgery experienced implant-related irritation.We found no benefits and only detrimental effects associated with rib fixation. Based on these results, we do not recommend rib fixation as the standard of care for patients with multiple rib fractures.Registered in the Netherlands Trial Register NTR6833 on 13/11/2017.

Although research on psychological contract breach (PCB) has grown in recent years, most of the studies have taken an individual-level perspective to explain PCB effects on employee behavior, thereby overlooking the possibility that the national cultural context might affect employee responses to psychological contracts. This study, therefore, investigates whether employees in various cultures react differently to psychological contract breaches. Drawing on the GLOBE cultural framework, we expected that national cultural practices moderate the relationship between PCB and a key work attitude (such as organizational commitment) and job behaviors (i.e. in-role performance, turnover intention, and counterproductive behaviours). Using meta-analytic data from 176 studies, we found that the results largely support our hypotheses. The study updates and expands prior meta-analyses on psychological contracts and opens a new area of inquiry by showing that cultural practices at the national level can influence the processes of how psychological contract breaches affect employee behaviors at the individual level.

Background In recent years, there has been a growing interest in operative treatment for multiple rib fractures and flail chest. However, to date, there is no comprehensive study that extensively focused on the incidence of complications associated with rib fracture fixation. Furthermore, there is insufficient knowledge about the short- and long-term outcomes after rib fracture fixation. Methods This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The MEDLINE, EMBASE, and Cochrane databases were searched to identify studies reporting on complications and/or outcome of surgical treatment after rib fractures. Complications were subdivided into (1) surgery- and implant-related complications, (2) bone-healing complications, (3) pulmonary complications, and (4) mortality. Results Forty-eight studies were included, with information about 1,952 patients who received rib fracture fixation because of flail chest or multiple rib fractures. The overall risk of surgery- and implant-related complications was 10.3%, with wound infection in 2.2% and fracture-related infection in 1.3% of patients. Symptomatic nonunion was a relatively uncommon complication after rib fixation (1.3%). Pulmonary complications were found in 30.9% of patients, and the overall mortality was 2.9%, of which one third appeared to be the result of the thoracic injuries and none directly related to the surgical procedure. The most frequently used questionnaire to assess patient quality of life was the EuroQol-5D (EQ-5D) (n = 4). Four studies reporting on the EQ-5D had a weighted mean EQ-5D index of 0.80 indicating good quality of life after rib fracture fixation. Conclusion Surgical fixation can be considered as a safe procedure with a considerably low complication risk and satisfactory long-term outcomes, with surgery- and implant-related complications in approximately 10% of the patients. However, the clinically most relevant complications such as infections occur infrequently, and the number of complications requiring immediate (surgical) treatment is low. Level of evidence Systematic Review, level III.

Literature on Shared Mental Models (SMMs) has been burgeoning in recent years and this has provided increasingly detailed insight and evidence into the importance of SMMs within specific contexts. However, because past research predominantly focused on SMM structure as measured by diverse, context-dependent measures, a consolidated multi-dimensional measure of perceived SMMs that can be used across diverse team contexts is currently lacking. Furthermore, different conceptualizations of the dimensionality of SMMs exist, which further impedes the comparison between studies. These key limitations might hinder future development in the SMM literature. We argue that the field of SMMs has now matured enough that it is possible to take a deductive approach and evaluate the prior studies in order to refine the key SMMs dimensions, operationalizations, and measurement. Hence, we take a three-stage approach to consolidate existing literature scale-based measures of SMMs, using four samples. Ultimately, this leads to a 20-item five-dimensional scale (i.e., equipment, execution, interaction, composition, and temporal SMMs) – the Five Factor Perceived Shared Mental Model Scale (5-PSMMS). Our scale provides scholars with a tool which enables the measurement, and comparison, of SMMs across diverse team contexts. It offers practitioners the option to more straightforwardly assess perceived SMMs in their teams, allowing the identification of challenges in their teams and facilitating the design of appropriate interventions.

Introduction In 1999 an inclusive trauma system was initiated in the Netherlands and a nationwide trauma registry, including all admitted trauma patients to every hospital, was started. The Dutch trauma system is run by trauma surgeons who treat both the truncal (visceral) and extremity injuries (fractures). Materials and Methods In this comprehensive review based on previous published studies, data over the past 20 years from the central region of the Netherlands (Utrecht) was evaluated. Results It is demonstrated that the initiation of the trauma systems and the governance by the trauma surgeons led to a region-wide mortality reduction of 50% and a mortality reduction for the most severely injured of 75% in the level 1 trauma centre. Furthermore, major improvements were found in terms of efficiency, demonstrating the quality of the current system and its constructs such as the type of surgeon. Due to the major reduction in mortality over the past few years, the emphasis of trauma care evaluation shifts towards functional outcome of severely injured patients. For the upcoming years, centralisation of severely injured patients should also aim at the balance between skills in primary resuscitation and surgical stabilization versus longitudinal surgical involvement. Conclusion Further centralisation to a limited number of level 1 trauma centres in the Netherlands is necessary to consolidate experience and knowledge for the trauma surgeon. The future trauma surgeon, as specialist for injured patients, should be able to provide the vast majority of trauma care in this system. For the remaining part, intramural, regional and national collaboration is essential

Background There is significant need for accurate diagnostic tools for Cryptosporidium spp. and Giardia duodenalis infections in resource limited countries where diarrhoeal disease caused by these parasites is often prevalent. The present study assessed the diagnostic performance of three commercially available rapid diagnostic tests (RDTs) based on faecal-antigen detection for Cryptosporidium spp. and/or G. duodenalis infections in stool samples of children admitted with severe acute malnutrition (SAM) and diarrhoea. An established multiplex PCR was used as reference test. Methods Stool samples from children with SAM and diarrhoea enrolled in a randomized controlled trial (registered at clinicaltrials.gov/ct2/show/NCT02246296) in Malawi (n = 175) and Kenya (n = 120) between December 2014 and December 2015 were analysed by a multiplex PCR for the presence of Cryptosporidium spp., G. duodenalis or Entamoeba histolytica parasite DNA. Cryptosporidium-positive samples were species typed using restriction fragment length polymorphism analysis. A sub-sample of the stool specimens (n = 236) was used for testing with three different RDTs. Diagnostic accuracy of the tests under evaluation was assessed using the results of PCR as reference standard using MedCalc software. Pearson Chi-square test and Fisher’s exact test were used to determine (significant) difference between the number of cryptosporidiosis or giardiasis cases found by PCR in Malawi and Kenya. The overall diagnostic accuracy of each RDT was calculated by plotting a receiver operating characteristic (ROC) curve for each test and to determine the area under the curve (AUC) using SPSS8 software. Results Prevalence of Cryptosporidium spp. by PCR was 20.0 and 21.7% in Malawi and Kenya respectively, mostly C. hominis. G. duodenalis prevalence was 23.4 and 5.8% in Malawi and Kenya respectively. E. histolytica was not detected by PCR. RDT testing followed the same pattern of prevalence. RDT sensitivities ranged for cryptosporidiosis from 42.9 to 76.9% and for G. duodenalis from 48.2 to 85.7%. RDT specificities ranged from 88.4 to 100% for Cryptosporidium spp. and from 91.2 to 99.2% for G. duodenalis infections. Based on the estimated area under the curve (AUC) values, all tests under evaluation had an acceptable overall diagnostic accuracy (> 0.7), with the exception of one RDT for Cryptosporidium spp. in Malawi. Conclusions All three RDTs for Cryptosporidium spp. and Giardia duodenalis evaluated in this study have a moderate sensitivity, but sufficient specificity. The main value of the RDTs is within their rapidness and their usefulness as screening assays in surveys for diarrhoea.

BACKGROUND: The standardized approach with triple diagnostics (surgical exploration with visual inspection, microbiological and histological examination) has been proposed as the golden standard for early diagnosis of severe necrotizing soft tissue disease (SNSTD, or necrotizing fasciitis) in ambivalent cases. This study's primary aim was to evaluate the protocolized approach after implementation for diagnosing (early) SNSTD and relate this to clinical outcome. METHODS: A cohort study analyzing a 5-year period was performed. All patients undergoing surgical exploration (with triple diagnostics) for suspected SNSTD since implementation were prospectively identified. Demographics, laboratory results and clinical outcomes were collected and analyzed. RESULT: Thirty-six patients underwent surgical exploration with eight (22%) negative explorations. The overall 30-day mortality rate was 25%, with an early, SNSTD-related mortality rate of 11% (n = 3). Of these, one patient (4%) underwent primary amputation, but died during surgery. No significant differences between baseline characteristics were found between patients diagnosed with SNSTD in early/indistinctive or late/obvious stage. Patient diagnosed at an early stage had a significantly shorter ICU stay (2 vs. 6 days, p = 0.031). Mortality did not differ between groups; patients who died were all ASA IV patients. CONCLUSION: Diagnosing SNSTD using the approach with triple diagnostics resulted in a low mortality rate and only a single amputation in a pre-terminal patient in the first 5 years after implementation. All deceased patients had multiple preexisting comorbidities consisting of severe systemic diseases, such as end-stage heart failure. Early detection proved to facilitate faster recovery with shorter ICU stay.

PurposeThis paper contains a meta-analysis of the psychological contract literature published in the last two decades. The aim of this paper was to investigate the moderating role of national culture in the individual-level relationships between psychological contract breach (PCB) and two important work outcomes, namely job performance (in-role and organizational citizenship behaviors) and turnover (actual and intended).Design/methodology/approachAfter an extensive literature search, 134 studies were found which matched the authors’ aim. The authors then incorporated national cultural scores based on the GLOBE study to include country-level scores to identify how the PCB relationships with these four outcomes vary across cultures.FindingsThe findings indicate that national cultural practices moderated the associations between PCB and the four outcomes, yet, no significant moderations for uncertainty avoidance practices.Originality/valueWhile existing research has examined the impact of the breach on work outcomes such as job performance and turnover, there are few empirical studies that examine how national cultural practices influence the relationships between psychological contract breach and job performance and turnover. The authors address this need by investigating and creating a deeper insight into how cultural practices such as institutional collectivism, performance-orientation, power-distance, future orientation and gender egalitarianism moderate the relationships between PCB and job performance and turnover.

PurposeThe purpose of this paper is to explore the macroeconomic factors that may moderate the psychological contract breach (PCB) and work outcome relationship.Design/methodology/approachThis study conducted a meta-analysis based on data from 134 studies.FindingsThe study revealed that the inflation rate and the unemployment rate of a country moderated the association among employee PCB, job performance and turnover.Research limitations/implicationsThe availability of more detailed macroeconomic data against the PCB and outcome relationship for other countries and studies examining the impact of micro-economic data for PCB and outcome relationship would provide a better understanding of the context.Practical implicationsThe authors believe that the results highlight the importance of the national economy since it impacts individual outcomes following a breach.Social implicationsEmployment policies to capture the impact of macroeconomic circumstances as discussed.Originality/valueOne of the valuable contributions made by this paper is that the authors capture the current accumulative knowledge regarding the breach and performance and breach and turnover relationship. Second, the study examines how the inflation rate and unemployment rate could moderate the association between PCB and job performance and turnover.

Prolific research suggests identity associates with pro-environmental behaviours (PEBs) that are individual and/or group focused. Individual PEB is personally driven, self-reliant, and are conducted on one's own (e.g., home recycling). Group focused PEB is other people-reliant and completed as part of a group (e.g., attending meetings of an environmental organisation). A wide range of identities have been related to PEBs. For example, a recent systematic qualitative review revealed 99 different types of identities studied in a PEB context. Most studies were correlational, few had an experimental design. However, the relationships between all these identities and PEBs have so far not been tested quantitatively with meta-analytical techniques. As such, a clear overview of this field is currently lacking. Due to the diverse nature of the field, a priori hypotheses were not possible and relatively broad definitions of identity had to be used to encompass all types of identities and the diverse meanings of identity that have been included in PEB research. What prior theory did allow for was to assess the distinction between two main types of identity, namely how people label, describe, and recognise oneself individually (individual identity), or as part of a group (group identity). Our overall goal was thus to assess the current state of knowledge on identities and PEBs. In 104 studies using a meta-regression following the preferred reporting items for systematic reviews and meta-analyses guidelines, our random-effects meta-analysis showed that the overall concept of identity associated with PEB with a medium Pearson's r (Aim 1). Furthermore, we found that individual identities associated more strongly with PEBs than group identities (Aim 2). The associations between individual and group identities were stronger when the identity and PEB were from the same category (e.g., when both were group-focused; Aim 3). Methodologically, the findings revealed that group identities and group PEBs were most strongly associated for self-reported rather than observed PEBs (Aim 4). Overall identity associated most strongly with group PEBs in the field rather than in the lab (Aim 5) and in student- rather than non-student samples (Aim 6). We discuss the theoretical and practical implications.

Purpose The aim of this systematic review was to provide an overview of the incidence of combined clavicle and rib fractures and the association between these two injuries. Methods A systematic literature search was performed in the MEDLINE, EMBASE, and CENTRAL databases on the 14th of August 2020. Outcome measures were incidence, hospital length of stay (HLOS), intensive care unit admission and length of stay (ILOS), duration of mechanical ventilation (DMV), mortality, chest tube duration, Constant–Murley score, union and complications. Results Seven studies with a total of 71,572 patients were included, comprising five studies on epidemiology and two studies on treatment. Among blunt chest trauma patients, 18.6% had concomitant clavicle and rib fractures. The incidence of rib fractures in polytrauma patients with clavicle fractures was 56–60.6% versus 29% in patients without clavicle fractures. Vice versa, 14–18.8% of patients with multiple rib fractures had concomitant clavicle fractures compared to 7.1% in patients without multiple rib fractures. One study reported no complications after fixation of both injuries. Another study on treatment, reported shorter ILOS and less complications among operatively versus conservatively treated patients (5.4 ± 1.5 versus 21 ± 13.6 days). Conclusion Clavicle fractures and rib fractures are closely related in polytrauma patients and almost a fifth of all blunt chest trauma patients sustain both injuries. Definitive conclusions could not be drawn on treatment of the combined injury. Future research should further investigate indications and benefits of operative treatment of this injury.

We explore whether, and how, Top Management Team (TMT) cohesion can affect the collective turnover intentions of employees, through two interrelated interface processes. Based on Social Information Processing theory, we propose that the organization's corrosive climate and non-TMT managers' transformational leadership transmit TMT cohesion-based symbolic and relational information through a moderated-mediation model. The results of our Structural Equations Modelling (SEM) analyses of a multi-source dataset of 96 organizations—including 305 TMT members and 10964 employees split across three surveys—support our hypotheses. Confirmatory Factor Analyses support our measurement model, and the testing of various alternative models indicate that our findings are robust. Overall, our theory and findings highlight a more complex interface perspective on how the TMT affects employees, as key internal stakeholders, and provides a comprehensive model for future work.

We develop and test a dynamic perspective into the ways in which voice behavior and employee silence develop in organizational newcomers. Unlike prior cross-sectional research, we focus on the differences in changes of voice behavior—distinguishing between promotive and prohibitive voice behavior—and employee silence. We suggest that these changes in employee voice and silence depend on the degree to which organizational newcomers understand and adjust to organizational norms, goals, and values (i.e., organizational socialization). We draw from multiple goal pursuit theory to substantiate our hypotheses which we test on 198 organizational newcomers across four waves of data. Using random coefficient growth models, we find employee voice and silence to develop along relatively independent trajectories and provide partial evidence for the influence of organizational socialization on these changes in newcomer behavior. Implications for theory and practice are discussed

Literature on Shared Mental Models (SMMs) has been burgeoning in recent years. Although this has provided increasingly detailed insight and evidence into the importance of SMMs across contexts, it has also become apparent that there are key limitations which might hinder future development. First, SMMs are operationalized and measured via in-depth, context dependent measures, which complicates the creation of a coherent body of knowledge. Second, different conceptualizations of the dimensionality of SMMs exist, which may complicate the comparison findings from different studies. We argue that the field of SMMs has now matured enough that it is possible to take a deductive approach and evaluate the prior studies in order to refine the key SMMs dimensions and operationalizations. Hence, we take a three-stage approach to distil measurement items from the literature, using four samples to do so. Ultimately, this leads to a 30-item five-dimensional scale (i.e., equipment, task execution, interaction, team composition, and temporal SMMs) which provides scholars with a tool which enables the measurement, and comparison, of SMMs across diverse team contexts. It offers practitioners the option to straightforwardly assess SMMs in their teams, allowing them to more readily identify challenges in their teams and design appropriate interventions for improvement.

Purpose Rib fixation for flail chest has been shown to improve in-hospital outcome, but little is known about treatment for multiple rib fractures and long-term outcome is scarce. The aim of this study was to describe the safety, long-term quality of life, and implant-related irritation after rib fixation for flail chest and multiple rib fractures. Methods All adult patients with blunt thoracic trauma who underwent rib fixation for flail chest or multiple rib fractures between January 2010 and December 2016 in our level 1 trauma facility were retrospectively included. In-hospital characteristics and implant removal were obtained via medical records and long-term quality of life was assessed over the telephone. Results Of the 864 patients admitted with ≥ 3 rib fractures, 166 (19%) underwent rib fixation; 66 flail chest patients and 99 multiple rib fracture patients with an ISS of 24 (IQR 18–34) and 21 (IQR 16–29), respectively. Overall, the most common complication was pneumonia (n = 58, 35%). Six (9%) patients with a flail chest and three (3%) with multiple rib fractures died, only one because of injuries related to the thorax. On average at 3.9 years, follow-up was obtained from 103 patients (62%); 40 with flail chest and 63 with multiple rib fractures reported an EQ-5D index of 0.85 (IQR 0.62–1) and 0.79 (0.62–0.91), respectively. Forty-eight (48%) patients had implant-related irritation and nine (9%) had implant removal. Conclusions We show that rib fixation is a safe procedure and that patients reported a relative good quality of life. Patients should be counseled that after rib fixation approximately half of the patients will experience implant-related irritation and about one in ten patients requires implant material removal. Electronic supplementary material The online version of this article (10.1007/s00068-018-1009-5) contains supplementary material, which is available to authorized users.

Summary Background Among patients admitted to European hospitals or intensive care units (ICUs), 5.7% and 19.5% will encounter healthcare-associated infections (HAIs), respectively, and antimicrobial resistance is emerging. As hospital surfaces are contaminated with potentially pathogenic bacteria, environmental cleanliness is an essential aspect to reduce HAIs. Aim To address the efficacy of a titanium dioxide coating in reducing the microbial colonization of environmental surfaces in an ICU. Methods A prospective, controlled, single-centre pilot study was conducted to examine the effect of a titanium dioxide coating on the microbial colonization of surfaces in an ICU. During the pre- and post-intervention periods, surfaces were cultured with agar contact plates (BBL RODAC plates). Factors that were potentially influencing the bacterial colonization of surfaces were recorded. A repeated measurements analysis within a hierarchic multi-level framework was used to analyse the effect of the intervention, controlling for the explanatory variables. Findings The mean ratio for the total number of colony-forming units (cfus) in a room between the pre- and post-intervention periods was 0.86 (standard deviation 0.57). The optimal model included the following explanatory variables: intervention ( P =0.065), week ( P =0.002), culture surfaces ( P P =0.039), and interaction between intervention and week ( P =0.002) and between week and culture surfaces ( P =0.031). The effect of the intervention on the number of cfus from all culture plates in Week 4 between the pre- and post-intervention periods was -0.47 (95% confidence interval -0.24 to - 0.70). Conclusion This study found that a titanium dioxide coating had no effect on the microbial colonization of surfaces in an ICU.

Introduction In contrast to the emerging evidence on the operative treatment of flail chest, there is a paucity of literature on the surgical treatment of rib fracture nonunion. The purpose of this study was to describe our standardized approach and report the outcome (e.g. patient satisfaction, pain and complications) after surgical treatment of a rib fracture nonunion. Methods A single centre retrospective cohort study was performed at a level 1 trauma centre. Symptomatic rib nonunion was defined as a severe persistent localized pain associated with the nonunion of one or more rib fractures on a chest CT scan at least 3 months after the initial trauma. Patients after initial operative treatment of rib fractures were excluded. Results Nineteen patients (11 men, 8 women), with symptomatic nonunions were included. Fourteen patients were referred from other hospitals and 8 patients received treatment from a pain medicine specialist. The mean follow-up was 36 months. No in-hospital complications were observed. In 2 patients, new fractures adjacent to the implant, without new trauma were observed. Furthermore 3 patients requested implant removal with a persistent nonunion in one patient. There was a mean follow-up of 36 months, the majority of patients (n = 13) were satisfied with the results of their surgical treatment and all patients experienced a reduction in the number of complaints. Persisting pain was a common complaint. Three patients reporting severe pain used opioid analgesics on a daily or weekly basis. Only 1 patient needed ongoing treatment by a pain medicine specialist. Conclusion Surgical fixation of symptomatic rib nonunion is a safe and feasible procedure, with a low perioperative complication rate, and might be beneficial in selected symptomatic patients in the future. In our study, although the majority of patients were satisfied and the pain level subjectively decreases, complaints of persistent pain were common.

Purpose Many studies report on outcomes of analgesic therapy for (suspected) traumatic rib fractures. However, the literature is inconclusive and diverse regarding the management of pain and its effect on pain relief and associated complications. This systematic review and meta-analysis summarizes and compares reduction of pain for the different treatment modalities and as secondary outcome mortality during hospitalization, length of mechanical ventilation, length of hospital stay, length of intensive care unit stay (ICU) and complications such as respiratory, cardiovascular, and/or analgesia-related complications, for four different types of analgesic therapy: epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks. Methods PubMed, EMBASE and CENTRAL databases were searched to identify comparative studies investigating epidural, intravenous, paravertebral and intercostal interventions for traumatic rib fractures, without restriction for study type. The search strategy included keywords and MeSH or Emtree terms relating blunt chest trauma (including rib fractures), analgesic interventions, pain management and complications. Results A total of 19 papers met our inclusion criteria and were finally included in this systematic review. Significant differences were found in favor of epidural analgesia for the reduction of pain. No significant differences were observed between epidural analgesia, intravenous analgesia, paravertebral blocks and intercostal blocks, for the secondary outcomes. Conclusions Results of this study show that epidural analgesia provides better pain relief than the other modalities. No differences were observed for secondary endpoints like length of ICU stay, length of mechanical ventilation or pulmonary complications. However, the quality of the available evidence is low, and therefore, preclude strong recommendations.

SUMMARYIn April 2015, Finnish public health authorities alerted European Union member states of a possible multi-countrySalmonella enteritidisoutbreak linked to an international youth ice-hockey tournament in Latvia. The European Centre for Disease Prevention and Control (ECDC), Finnish and Latvian authorities initiated an outbreak investigation to identify the source. The investigation included a description of the outbreak, retrospective cohort study, microbiological investigation and trace-back. We identified 154 suspected and 96 confirmed cases from seven countries. Consuming Bolognese sauce and salad at a specific event arena significantly increased the risk of illness. Isolates from Finnish, Swedish and Norwegian cases had an identical multiple-locus variable-number of tandem repeats analysis-profile (3-10-6-4-1). Breaches in hygiene and food storing practices in the specific arena's kitchen allowing for cross-contamination were identified. Riga Cup participants were recommended to follow good hand hygiene and consume only freshly cooked foods. This investigation demonstrated that the use of ECDC's Epidemic Intelligence Information System for Food- and Waterborne Diseases and Zoonoses platform was essential to progress the investigation by facilitating information exchange between countries. Cross-border data sharing to perform whole genome sequencing gave relevant information regarding the source of the outbreak.

Purpose The aim of this systematic review and meta-analysis was to present current evidence on rib fixation and to compare effect estimates obtained from randomized controlled trials (RCTs) and observational studies. Methods MEDLINE, Embase, CENTRAL, and CINAHL were searched on June 16th 2017 for both RCTs and observational studies comparing rib fixation versus nonoperative treatment. The MINORS criteria were used to assess study quality. Where possible, data were pooled using random effects meta-analysis. The primary outcome measure was mortality. Secondary outcome measures were hospital length of stay (HLOS), intensive care unit length of stay (ILOS), duration of mechanical ventilation (DMV), pneumonia, and tracheostomy. Results Thirty-three studies were included resulting in 5874 patients with flail chest or multiple rib fractures: 1255 received rib fixation and 4619 nonoperative treatment. Rib fixation for flail chest reduced mortality compared to nonoperative treatment with a risk ratio of 0.41 (95% CI 0.27, 0.61, p

PURPOSE: Traumatic sternal fractures are rare injuries. The most common mechanism of injury is direct blunt trauma to the anterior chest wall. Most (> 95%) sternal fractures are treated conservatively. Surgical fixation is indicated in case of fracture instability, displacement or non-union. However, limited research has been performed on treatment outcomes. This study aimed to provide an overview of the current treatment practices and outcomes of traumatic sternal fractures and dislocations. METHODS: A systematic review of literature published from 1990 to June 2017 was conducted. Original studies on traumatic sternal fractures, reporting sternal healing or sternal stability were included. Studies on non-traumatic sternal fractures or not reporting sternal healing outcomes, as well as case reports (n = 1), were excluded. RESULTS: Sixteen studies were included in this review, which reported treatment outcomes for 191 patients. Most included studies were case series of poor quality. All patients showed sternal healing and 98% reported pain relief. Treatment complications occurred in 2% of patients. CONCLUSIONS: Treatment of traumatic sternal fractures and dislocations is an underexposed topic. Although all patients in this review displayed sternal healing, results should be interpreted with caution since most included studies were of poor quality.

Traditioneel gezien heeft veel onderzoek op het gebied van organisatiegedrag, management en personeelsbeleid als impliciete assumptie dat er sprake is van een zekere symmetrie in de onderzochte relaties en fenomenen. Deze assumptie is niet verwonderlijk, aangezien symmetrie (en balans, harmonie e.d.) ook centraal staat in andere wetenschappen. In deze bewerking van mijn oratie stel ik dat het wenselijk is om vaker stil te staan bij dit soort impliciete assumpties tijdens onze wetenschappelijke onderzoeken en praktijkinterventies. Om dat belang te illustreren geef ik een overzicht van recent onderzoek naar asymmetrieën in taakafhankelijkheid, waaruit duidelijk wordt dat het negeren van deze asymmetrieën belangrijke machtsdynamieken over het hoofd ziet. Naast het bespreken van dit soort specifieke 'horizontale' (a)symmetrieën laat ik ook meer algemene 'verticale' asymmetrieën aan bod komen door onderzoek op het gebied van leiderschap en 'HR-practices' te beschrijven. Toekomstig onderzoek kan horizontale en verticale (a)symmetrieën verder onderzoeken in de aparte theoretische velden en/of proberen de velden te 'kruisbestuiven' door de (a)symmetrieën van één veld in het andere veld te onderzoeken. Daarnaast kunnen er tijds(a)symmetrieën onderzocht worden, bijvoorbeeld door meer longitudinaal onderzoek te verrichten. De implicaties voor wetenschap en praktijk (en hun onderlinge samenhang) worden besproken aan het einde van het artikel.

Despite the wealth of research showing that psychological contract breach (PCB) has negative outcomes for individuals, knowledge about the influence of the social context in which breaches are experienced is still scarce. This is surprising, as scholars have argued that work climates, such as when unit members are generally highly committed, could buffer an individual's negative experiences at work. Yet, to date, the unit climate and PCB literatures have largely remained separated and our main goal is to integrate these fields. This is especially timely and relevant, because recent work in the unit climate literature indicates that merely looking at the average climate level might not be enough, because the climate's strength (i.e., the agreement or homogeneity within the unit) could also provide important social cues. Building on these recent advances, we develop and test a theoretical framework which links both climate concepts to PCB. More specifically, we hypothesized that especially when all unit members are highly and homogeneously committed, an employee would reframe their PCB in such a way that it would less adversely affect work engagement and turnover intentions. Using data from 1,272 employees across 36 healthcare units, multilevel structural path analyses supported this three-way interaction. By answering recent calls for more "social PCB research" and integrating the unit climate and PCB literatures, we aim to provide guidance to scholars and practitioners who want to understand in more depth the social context's influence on PCB.

Background. Adequate pain control is essential in the treatment of patients with traumatic rib fractures. Although epidural analgesia is recommended in international guidelines, the use remains debatable and is not undisputed. The aim of this study was to describe the efficacy and safety of epidural analgesia in patients with multiple traumatic rib fractures.Methods. A retrospective cohort study was performed. Patients with ≥3 rib fractures following blunt chest trauma who received epidural analgesia between January 2015 and January 2018 were included. The main outcome parameters were the success rate of epidural analgesia and the incidence of medication-related side effects and catheter-related complications.Results. A total of 76 patients were included. Epidural analgesia was successful in a total of 45 patients (59%), including 22 patients without and in 23 patients with an additional analgesic intervention. In 14 patients (18%), epidural analgesia was terminated early without intervention due to insufficient sensory blockade (n=4), medication-related side effects (n=4), and catheter-related complications (n=6). In 17 patients (22%), the epidural catheter was removed after one or multiple additional interventions due to insufficient pain control. Minor epidural-related complications or side effects were encountered in 36 patients (47%). One patient had a major complication (opioid intoxication).Conclusion. Epidural analgesia was successful in 59% of patients; however, 30% needed additional analgesic interventions. As about half of the patients had epidural-related complications, it remains debatable whether epidural analgesia is a sufficient treatment modality in patients with multiple rib fractures.

Workplace loneliness, and its negative effects such as stress and reduced job performance, seem especially relevant in the fast-growing e-working environment and even more so recently with strict social distancing and home-working measures taken due to the COVID-19 pandemic. During e-working, employees are not only subject to different demands and support structures at work, but also at home, yet these two sides have so far not been investigated in the workplace loneliness literature. Drawing on job demands-resource (JD-R) theory and the workplace loneliness literature, we suggest job and home demands as antecedents to workplace loneliness, work-home interference and home-work interference as mediators, and job and home support as moderators. We conducted a two wave study of at remote-working, white-collar employees in Germany during the COVID-19 pandemic. We found that job demands increased workplace loneliness through heightened work-home interference and this relationship was buffered by job support. Home demands increased workplace loneliness through heightened home-work interference, but this relationship was not buffered by home support. We contribute to the workplace loneliness literature by identifying important antecedents of and possible remedies for workplace loneliness.

This study integrates recent advances in interdependence theory with the literature on commitment-based HR practices. New research on interdependence theory suggests that differences, or asymmetries, in task dependence among organisational members can cause interests to diverge. Prior research has shown that this can negatively affect interpersonal relations, individual outcomes and team processes. However, these insights gained on the dyadic, individual and team levels of analysis have not yet been explored at the organisational level and, until now, no research had yet connected these advances in interdependence theory to the field of HRM research. Hence, the current study investigates (a) whether asymmetries in task dependence do (or do not) matter at the organisational level and affect organisational effectiveness, (b) why this relationship may work by assessing a key mediator, namely, trust climate and (c) if and how these relationships can be altered by commitment-based HR practices. Our moderated-mediation model was tested and fully supported by a multi-source data set of 8,390 employees from 67 organisations.

Introduction There is continuous drive to optimize healthcare for the most severely injured patients. Although still under debate, a possible measure is to provide 24/7 in-house (IH) coverage by trauma surgeons. The aim of this study was to compare process-related outcomes for severely injured patients before and after transition of attendance policy from an out-of-hospital (OH) on-call attending trauma surgeon to an in-house attending trauma surgeon. Methods Retrospective before-and-after study using prospectively gathered data in a Level 1 Trauma Center in the Netherlands. All trauma patients with an Injury Severity Score (ISS) >24 presenting to the emergency department for trauma before (2011–2012) and after (2014–2016) introduction of IH attendings were included. Primary outcome measures were the process-related outcomes Emergency Department length of stay (ED-LOS) and time to first intervention. Results After implementation of IH trauma surgeons, ED-LOS decreased (p = 0.009). Time from the ED to the intensive care unit (ICU) for patients directly transferred to the ICU was significantly shorter with more than doubling of the percentage of patients that reached the ICU within an hour. The percentage of patients undergoing emergency surgery within 30 min nearly doubled as well, with a larger amount of patients undergoing CT imaging before emergency surgery. Conclusions Introduction of a 24/7 in-house attending trauma surgeon led to improved process-related outcomes for the most severely injured patients. There is clear benefit of continuous presence of physicians with sufficient experience in trauma care in hospitals treating large numbers of severely injured patients.

Voice behavior–the upward communication of challenging, but constructive ideas, suggestions, and concerns–is critical to organizational innovation, safety, and performance. However, supervisors not...

This study integrates recent advances in interdependence theory with the literatures on intra-team conflicts and motivation-enhancing HR practices. More specifically, we investigate if intrinsic and/or extrinsic motivation-enhancing HR practices are better suited to reduce conflicts in asymmetrically task dependent teams. We contribute to these literatures by exploring a key mechanism (i.e. intra-team conflicts) which prior studies assumed – but never tested – to underlie the relationship between asymmetries in task dependence and negative team outcomes. Such asymmetries occur when team members differ in their reliance on others for resources required to perform their tasks, something that occurs frequently in today’s complex business world. Second, we contribute by linking asymmetries in task dependence to the motivation-enhancing HR literature. We theorize that intrinsic and extrinsic HR-practices provide an important context in teams that shapes the associations between asymmetries and intra-team conflicts. Multi-level analyses of a dual-source dataset containing 146 employees and 44 team leaders showed a significant three-way interaction between asymmetric interdependence, extrinsic, and intrinsic HR in relation to intra-team conflicts. This revealed that conflicts in asymmetrically task dependent teams were only reduced when extrinsic HR practices were low and intrinsic HR practices were high. Practically our study contributes by showing that different forms of motivation-enhancing HR practices can have different effects in asymmetrically dependent teams and thus need to be selected with care by practitioners.

Encouraging pro‐environmental behaviour (PEB) is an environmental and societal concern. Encouraging PEB focussing on how consumers see themselves (their identity) has blossomed. However, a theoretical assessment of this research is missing. Three main identity theories seem to best explain the research, specifically, and two‐fold, identity, and social identity theory (SIT), collectively known as the unified identity theory (UIT), and place identity theory (PIT). As these theories overlap more than differ in their understanding of identity, we argue that combining these theories is needed to avoid redundancies in identity theorizing, provide a universal approach to identity in terms of the processes and outcomes, and explain the PEB research most succinctly. Therefore, we understand identity similarly between the theories and offer a universal identity theory approach based on the theoretical definitions and assumptions. Finally, we demonstrate how the theory can be used to explain the research. Next, research was identified by conducting a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, where 62 studies were relevant. Multiple identities relevant for a given PEB are assumed and evidenced: 99. Identities are assumed to be either individually‐, group‐, and/or place‐focused, drawing on the specific subsets of the universal theory: identity theory, social identity theory, and place identity theory, respectively. Identities are assumed to relate to behaviour, where identity increased PEB with medium effect sizes. Finally, to move the field forward, we provide a theoretical framework of how to test identities in relation to other psychological variables relevant for PEB research. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2020 The Authors. Journal of Consumer Behaviour published by John Wiley & Sons, Ltd