Demanding and Supportive Transformational Leadership Behaviors and Follower Sleep Outcomes: A Multilevel Moderated Serial Mediation Model

Transformational leadership behaviors in the workplace are commonly studied as a form of support and are associated with positive follower health outcomes. However, when parsed apart into its facets, transformational leadership may also act as a demand for followers that negatively impacts them daily. Drawing from the Job-Demands Resources (JD-R) Theory (Bakker & Demerouti, 2007), this study investigated the facets of transformational leadership (Bass, 1985) acting differentially to influence follower sleep outcomes—first through the mediation of fatigue and then through performance of sleep hygiene behaviors—all at the daily level. The supportive facets of transformational leadership were thought to increase sleep quality and quantity at the daily level, while the demanding facets were proposed to decrease them. Because of the heightened response to stressors that neurotic individuals exhibit, neuroticism was explored as a moderating mechanism on the relationship between leader demands and fatigue. This study used a sample of 127 full-time, working adults and experience sampling methods over a 10-day period in order to measure these variables at the daily level. Ultimately, the proposed facets of supportive and transformational leadership were supported, but the proposed direct, mediating, and moderating relationships were not. This study contributes to theory is in its expansion of transformational leadership theory—pointing to a demanding and a supportive factor. Further research is warranted to explore the timeframe during which relationships between leader behavior and follower health outcomes unfold.M.S

Workforce Development Network Resource Directory: a Directory of Workforce Development Service Providers in Multnomah and Washington Counties

This resource directory was produced for the Workforce Development Network (WDN) by a group of graduate students in the Urban and Regional Planning masters program at Portland State University. The project team consisted of Kim Burnett, Ray Jackson, Britt Parrott, Mat Ransom, and Claire Smith. The information for the directory was collected through interviews with service providers identified by WDN and the Workforce development Board. The scope of the resource directory is limited to adult workforce development programs in Multnomah and Washington Counties and does not include temporary employment agencies or apprenticeship and pre-apprenticeship programs due to time and resource constraints. These programs, as well as programs for youth, are important components of workforce development. Services in the region and we recommend that they be inventoried and analyzed in the future

An investigation into physical activity levels in primary school playgrounds

Background: As children spend roughly 30 hours per week at school, the associated benefits of physical activity (PA) can be developed within Physical Education (PE) lessons, break times and after school activities. Methods: A mixed methods approach was undertaken to explore children’s PA levels and the effect of gender, adult supervision and weather during school lunchtimes using n = 132 participants aged 5-12 years. Moderate-to-vigorous (MPVA) PA levels were measured using systematic scans in 3 playground areas during 3 separate lunchtimes using an adapted version of McKenzie’s1 proforma. Focus groups on n = 16 pupils aged 7-11 years were conducted to help improve understanding of the effects of supervision and weather on PA, and how levels of PA can be increased. Results: Paired sample t-tests results revealed that males were significantly more active in area one than area two (P = 0.04) and females were significantly more active in area three than area one (P < 0.01). Focus groups highlighted that supervisors made little impact upon PA, whilst hotter weather was reported to negatively affect PA levels, as children engaged in less active activities to avoid sweating. Conclusions: Overall males were observed to have higher levels of PA during the study, supervisors were important for health and safety but rarely encouraged PA and finally, participants claimed that they were less active when it was hotter

Reexamining evidence-based practice in community corrections: beyond 'a confined view' of what works

This article aims to reexamine the development and scope of evidence-based practice (EBP) in community corrections by exploring three sets of issues. Firstly, we examine the relationships between the contested purposes of community supervision and their relationships to questions of evidence. Secondly, we explore the range of forms of evidence that might inform the pursuit of one purpose of supervision—the rehabilitation of offenders—making the case for a fuller engagement with “desistance” research in supporting this process. Thirdly, we examine who can and should be involved in conversations about EBP, arguing that both ex/offenders’ and practitioners’ voices need to be respected and heard in this debate

CIP2A- and SETBP1-mediated PP2A inhibition reveals AKT S473 phosphorylation to be a new biomarker in AML

Key Points PP2A inhibition occurs in AML by 2 different pathways: CIP2A in normal karyotype patients and SETBP1 in adverse karyotype patients. AKTS473 phosphorylation is a predictor of survival, and diagnostic levels of AKTS473 could be a novel biomarker in AML

Site staff perspectives on communicating trial results to participants: Cost and feasibility results from the Show RESPECT cluster randomised, factorial, mixed-methods trial

BACKGROUND/AIMS: Sharing trial results with participants is an ethical imperative but often does not happen. Show RESPECT (ISRCTN96189403) tested ways of sharing results with participants in an ovarian cancer trial (ISRCTN10356387). Sharing results via a printed summary improved patient satisfaction. Little is known about staff experience and the costs of communicating results with participants. We report the costs of communication approaches used in Show RESPECT and the views of site staff on these approaches. METHODS: We allocated 43 hospitals (sites) to share results with trial participants through one of eight intervention combinations (2 × 2 × 2 factorial; enhanced versus basic webpage, printed summary versus no printed summary, email list invitation versus no invitation). Questionnaires elicited data from staff involved in sharing results. Open- and closed-ended questions covered resources used to share results and site staff perspectives on the approaches used. Semi-structured interviews were conducted. Interview and free-text data were analysed thematically. The mean additional site costs per participant from each intervention were estimated jointly as main effects by linear regression. RESULTS: We received questionnaires from 68 staff from 41 sites and interviewed 11 site staff. Sites allocated to the printed summary had mean total site costs of sharing results £13.71/patient higher (95% confidence interval (CI): -3.19, 30.60; p = 0.108) than sites allocated no printed summary. Sites allocated to the enhanced webpage had mean total site costs £1.91/patient higher (95% CI: -14, 18.74; p = 0.819) than sites allocated to the basic webpage. Sites allocated to the email list had costs £2.87/patient lower (95% CI: -19.70, 13.95; p = 0.731) than sites allocated to no email list. Most of these costs were staff time for mailing information and handling patients' queries. Most site staff reported no concerns about how they had shared results (88%) and no challenges (76%). Most (83%) found it easy to answer queries from patients about the results and thought the way they were allocated to share results with participants would be an acceptable standard approach (76%), with 79% saying they would follow the same approach for future trials. There were no significant effects of the randomised interventions on these outcomes. Site staff emphasised the importance of preparing patients to receive the results, including giving opt-in/opt-out options, and the need to offer further support, particularly if the results could confuse or distress some patients. CONCLUSIONS: Adding a printed summary to a webpage (which significantly improved participant satisfaction) may increase costs to sites by ~£14/patient, which is modest in relation to the cost of trials. The Show RESPECT communication interventions were feasible to implement. This information could help future trials ensure they have sufficient resources to share results with participants

The Patient Feedback Response Framework – understanding why UK hospital staff find it difficult to make improvements based on patient feedback: A qualitative study

Patients are increasingly being asked for feedback about their healthcare experiences. However, healthcare staff often find it difficult to act on this feedback in order to make improvements to services. This paper draws upon notions of legitimacy and readiness to develop a conceptual framework (Patient Feedback Response Framework – PFRF) which outlines why staff may find it problematic to respond to patient feedback. A large qualitative study was conducted with 17 ward based teams between 2013 and 2014, across three hospital Trusts in the North of England. This was a process evaluation of a wider study where ward staff were encouraged to make action plans based on patient feedback. We focus on three methods here: i) examination of taped discussion between ward staff during action planning meetings ii) facilitators notes of these meetings iii) telephone interviews with staff focusing on whether action plans had been achieved six months later. Analysis employed an abductive approach. Through the development of the PFRF, we found that making changes based on patient feedback is a complex multi-tiered process and not something that ward staff can simply ‘do’. First, staff must exhibit normative legitimacy – the belief that listening to patients is a worthwhile exercise. Second, structural legitimacy has to be in place – ward teams need adequate autonomy, ownership and resource to enact change. Some ward teams are able to make improvements within their immediate control and environment. Third, for those staff who require interdepartmental co-operation or high level assistance to achieve change, organisational readiness must exist at the level of the hospital otherwise improvement will rarely be enacted. Case studies drawn from our empirical data demonstrate the above. It is only when appropriate levels of individual and organisational capacity to change exist, that patient feedback is likely to be acted upon to improve services

Readmissions after general surgery: a prospective multicenter audit

Background: Readmission rates after surgical procedures are viewed as a marker of quality of care and as a driver to improve outcomes in the United Kingdom, they are not remunerated. However, readmissions are not wholly avoidable. The aim of this study was to develop a regional overview of readmissions to determine the proportion that might be avoidable and to examine predictors of readmissions at a unit level. Methods: We undertook a prospective multicenter audit of readmissions following National Health Service funded general surgical procedures in five National Health Service hospitals and three independent sector providers over a 2-wk period. Basic demographic and procedure data were captured. Readmissions to hospitals were identified through acute admissions lists. Reason for readmission was identified, and the readmission data assessed by a senior surgical doctor as to whether it was avoidable. Results: We identified 752 operations in the study period with all followed up to 30 d. The overall rate of readmissions was 4.7%, with 40% of these judged as being potentially avoidable. Pain and wound problems accounted for the vast majority of avoidable readmissions. The number of unavoidable readmissions was correlated with the workload of each center (r ¼ 0.63, P ¼ 0.06) and as with the higher (British United Provident Association) complexity of surgery (r ¼ 0.90, P ¼ 0.01). Patient and demographic factors were not associated with readmissions. Conclusions: This prospective audit describes readmission rates after general surgery. Volume and complexity of work are associated with readmission rates. A large proportion of readmissions could be reduced by attention to analgesia and outpatient arrangements for wound management