Understanding the initiative paradox:the interplay of leader neuroticism and follower traits in evaluating the desirability of follower proactivity

This study investigates the relationship between leaders’ neuroticism and their evaluation of the desirability of followers’ proactive behaviour. We argue that leaders high in neuroticism are likely to evaluate follower proactivity as less desirable and that this relationship is amplified when followers are low in conscientiousness and agreeableness. Based on trait activation theory, we further propose that worry and threat act as underlying mechanisms of the interaction between these traits. We hypothesize that leaders high in neuroticism feel more threatened by the proactive behaviours shown by followers’ low in conscientiousness and agreeableness and rate the proactive behaviours of these followers as less desirable. In a field study with 205 leader–follower dyads (Study 1), we found the expected interaction effect. Leaders’ neuroticism interacted with their followers’ conscientiousness and agreeableness to predict their evaluation of the desirability of followers’ proactive behaviour. Study 2, an experimental vignette study, suggests a moderated indirect effect through the experience of threat, but not worry. We found no direct effects of leader neuroticism on the desirability ratings of followers’ proactive behaviour. This research emphasizes the value of investigating the interplay between leader and follower traits and the underlying cognitive-emotional processes for leader evaluations of followers’ proactivity

A pathway to solving the Wi-Fi tragedy of the commons in apartment blocks

Surprisingly little research has quantified the severity of Wi-Fi congestion in densely populated areas. We performed a high-fidelity 3D simulation of the performance of a realistic Wi-Fi deployment in a typical apartment block. Our results show that congestion leads to significant loss of performance, and that current channel selection procedures have only little effect. Also the strategy that is mostly applied today, i.e. to deploy additional repeaters and access points (APs), fails. As this is a typical example of the “Tragedy of the Commons”, some form of collaboration between AP operators is needed to solve the problem. New channel selection algorithms that optimize Wi-Fi performance on a system level then become possible which, for instance, minimize the mutual interference impact on all APs involved. We validate that such an algorithm indeed leads to an optimized as well as fair assignment, which is a necessary first step towards solving the Tragedy

Effect of the Dutch Hip Fracture Audit implementation on mortality, length of hospital stay and time until surgery in elderly hip fracture patients; a multi-center cohort study

Background: In 2040 the estimated number of people with a hip fracture in the Netherlands will be about 24,000. The medical care for this group of patients is complicated and challenging. Multidisciplinary approaches aim to improve clinical outcome. Quality indicators that gain insight in the treatment and outcome of hip fracture patients may help to optimize and monit

Association between prehospital end-tidal carbon dioxide levels and mortality in patients with suspected severe traumatic brain injury

Purpose: Severe traumatic brain injury is a leading cause of mortality and morbidity, and these patients are frequently intubated in the prehospital setting. Cerebral perfusion and intracranial pressure are influenced by the arterial partial pressure of CO2 and derangements might induce further brain damage. We investigated which lower and upper limits of prehospital end-tidal CO2 levels are associated with increased mortality in patients with severe traumatic brain injury. Methods: The BRAIN-PROTECT study is an observational multicenter study. Patients with severe traumatic brain injury, treated by Dutch Helicopter Emergency Medical Services between February 2012 and December 2017, were included. Follow-up continued for 1 year after inclusion. End-tidal CO2 levels were measured during prehospital care and their association with 30-day mortality was analyzed with multivariable logistic regression. Results: A total of 1776 patients were eligible for analysis. An L-shaped association between end-tidal CO2 levels and 30-day mortality was observed (p = 0.01), with a sharp increase in mortality with values below 35 mmHg. End-tidal CO2 values between 35 and 45 mmHg were associated with better survival rates compared to &lt; 35 mmHg. No association between hypercapnia and mortality was observed. The odds ratio for the association between hypocapnia (&lt; 35 mmHg) and mortality was 1.89 (95% CI 1.53–2.34, p &lt; 0.001) and for hypercapnia (≥ 45 mmHg) 0.83 (0.62–1.11, p = 0.212). Conclusion: A safe zone of 35–45 mmHg for end-tidal CO2 guidance seems reasonable during prehospital care. Particularly, end-tidal partial pressures of less than 35 mmHg were associated with a significantly increased mortality.</p

Epidemiology, Prehospital Characteristics and Outcomes of Severe Traumatic Brain Injury in The Netherlands:The BRAIN-PROTECT Study

Objective: A thorough understanding of the epidemiology, patient characteristics, trauma mechanisms, and current outcomes among patients with severe traumatic brain injury (TBI) is important as it may inform potential strategies to improve prehospital emergency care. The aim of this study is to describe the prehospital epidemiology, characteristics and outcome of (suspected) severe TBI in the Netherlands. Methods: The BRAIN-PROTECT study is a prospective observational study on prehospital management of patients with severe TBI in the Netherlands. The study population comprised all consecutive patients with clinical suspicion of TBI and a prehospital GCS score ≤ 8, who were managed by one of the 4 Helicopter Emergency Medical Services (HEMS). Patients were followed-up in 9 trauma centers until 1 year after injury. Planned sub-analyses were performed for patients with “confirmed” and “isolated” TBI. Results: Data from 2,589 patients, of whom 2,117 (81.8%) were transferred to a participating trauma center, were analyzed. The incidence rate of prehospitally suspected and confirmed severe TBI were 3.2 (95% CI: 3.1;3.4) and 2.7 (95% CI: 2.5;2.8) per 100,000 inhabitants per year, respectively. Median patient age was 46 years, 58.4% were involved in traffic crashes, of which 37.4% were bicycle related. 47.6% presented with an initial GCS of 3. The median time from HEMS dispatch to hospital arrival was 54 minutes. The overall 30-day mortality was 39.0% (95% CI: 36.8;41.2). Conclusion: This article summarizes the prehospital epidemiology, characteristics and outcome of severe TBI in the Netherlands, and highlights areas in which primary prevention and prehospital care can be improved

The impact of regionalized trauma care on the distribution of severely injured patients in the Netherlands

BACKGROUND: Twenty years ago, an inclusive trauma system was implemented in the Netherlands. The goal of this study was to evaluate the impact of structured trauma care on the concentration of severely injured patients over time. METHODS: All severely injured patients (Injury Severity Score [ISS] ≥ 16) documented in the Dutch Trauma Registry (DTR) in the calendar period 2008–2018 were included for analysis. We compared severely injured patients, with and without severe neurotrauma, directly brought to trauma centers (TC) and non-trauma centers (NTC). The proportion of patients being directly transported to a trauma center was determined, as was the total Abbreviated Injury Score (AIS), and ISS. RESULTS: The documented number of severely injured patients increased from 2350 in 2008 to 4694 in 2018. During this period, on average, 70% of these patients were directly admitted to a TC (range 63–74%). Patients without severe neurotrauma had a lower chance of being brought to a TC compared to those with severe neurotrauma. Patients directly presented to a TC were more severely injured, reflected by a higher total AIS and ISS, than those directly transported to a NTC. CONCLUSION: Since the introduction of a well-organized trauma system in the Netherlands, trauma care has become progressively centralized, with more severely injured patients being directly presented to a TC. However, still 30% of these patients is initially brought to a NTC. Future research should focus on improving pre-hospital triage to facilitate swift transfer of the right patient to the right hospital

Quasiclassical Green's function approach to mesoscopic superconductivity

Recent experiments on mesoscopic normal-metal--superconductor heterostructures resolve properties on length scales and at low temperatures such that the temperature is below the Thouless energy $k_B T \le E_{Th}$. We describe the properties of these systems within the framework of quasiclassical many-body techniques. Diffusive and ballistic systems are covered, both in equilibrium and nonequilibrium situations. Thereby we demonstrate the common physical basis of various subtopics.Comment: 38 pages, LaTeX, sup.sty-style file included, to appear in Superlattices and Microstructures; several minor changes and corrections of typographical errors, two updated figure