Effects of discontinuing performance pay : a qualitative analysis inthree brances of SpareBank 1 SMN

SpareBank 1 SMN, a regional bank consisting of 50 branches, recently decided to change their compensation policy. That meant for the bank to discontinue its performance pay scheme, and replace it with a new fixed pay scheme, namely a career model. The change happened due to a general dissatisfaction amongst the management with the consequences of using performance pay as a part of the compensation system, and it was in 2013 decided to discontinue further use of it and instead implement a career model based on fixed pay. This research was done using a qualitative method. In total, 17 interviews with employees working at 3 different branches (Stjørdal, Malvik, and Meråker) were conducted. The aims of the research was to find the employees’ perceptions and opinions concerning being deprived performance pay, in addition to reveal possible multitask problems that could have occurred due to the bank’s performance pay schemes. The findings revealed that the perceptions of the most recent performance pay schemes varied to a great extent. Performance pay seems to have motivated the majority of the interviewees, but the thesis also proposes that employee loyalty, and the level of effort put in, did not change significantly because of its discontinuation. However, the discontinuationnhhma

Acute cellular and molecular responses and chronic adaptations to low-load blood flow restriction and high-load resistance exercise in trained individuals

Blood flow restriction (BFR) with low-load resistance exercise (RE) is often used as a surrogate to traditional high-load RE to stimulate muscular adaptations, such as hypertrophy and strength. However, it is not clear whether such adaptations are achieved through similar cellular and molecular processes. We compared changes in muscle function, morphology, and signaling pathways between these differing training protocols. Twenty-one males and females (means ± SD: 24.3 ± 3.1 yr) experienced with resistance training (4.9 ± 2.6 yr) performed 9 wk of resistance training (three times per week) with either high-loads (75%-80% 1RM; HL-RT), or low-loads with BFR (30%-40% 1RM; LL-BFR). Before and after the training intervention, resting muscle biopsies were collected, and quadricep cross-sectional area (CSA), muscular strength, and power were measured. Approximately 5 days following the intervention, the same individuals performed an additional “acute” exercise session under the same conditions, and serial muscle biopsies were collected to assess hypertrophic- and ribosomal-based signaling stimuli. Quadricep CSA increased with both LL-BFR (7.4 ± 4.3%) and HL-RT (4.6 ± 2.9%), with no significant differences between training groups (P = 0.37). Muscular strength also increased in both training groups, but with superior gains in squat 1RM occurring with HL-RT (P 0.05 for between-group comparisons). Together, these findings validate low-load resistance training with continuous BFR as an effective alternative to traditional high-load resistance training for increasing muscle hypertrophy in trained individuals.</p

Cardiopulmonary resuscitation in adults over 80 : outcome and the perception of appropriateness by clinicians

OBJECTIVES: To determine the prevalence of clinician perception of inappropriate cardiopulmonary resuscitation (CPR) regarding the last out‐of‐hospital cardiac arrest (OHCA) encountered in an adult 80 years or older and its relationship to patient outcome. DESIGN: Subanalysis of an international multicenter cross‐sectional survey (REAPPROPRIATE). SETTING: Out‐of‐hospital CPR attempts registered in Europe, Israel, Japan, and the United States in adults 80 years or older. PARTICIPANTS: A total of 611 clinicians of whom 176 (28.8%) were doctors, 123 (20.1%) were nurses, and 312 (51.1%) were emergency medical technicians/paramedics. RESULTS AND MEASUREMENTS: The last CPR attempt among patients 80 years or older was perceived as appropriate by 320 (52.4%) of the clinicians; 178 (29.1%) were uncertain about the appropriateness, and 113 (18.5%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the “appropriate” subgroup was 8 of 265 (3.0%), 1 of 164 (.6%) in the “uncertain” subgroup, and 2 of 107 (1.9%) in the “inappropriate” subgroup (P = .23); 503 of 564 (89.2%) CPR attempts involved non‐shockable rhythms. CPR attempts in nursing homes accounted for 124 of 590 (21.0%) of the patients and were perceived as appropriate by 44 (35.5%) of the clinicians; 45 (36.3%) were uncertain about the appropriateness; and 35 (28.2%) perceived the CPR attempt as inappropriate. The survival to hospital discharge for the nursing home patients was 0 of 107 (0%); 104 of 111 (93.7%) CPR attempts involved non‐shockable rhythms. Overall, 36 of 543 (6.6%) CPR attempts were undertaken despite a known written do not attempt resuscitation decision; 14 of 36 (38.9%) clinicians considered this appropriate, 9 of 36 (25.0%) were uncertain about its appropriateness, and 13 of 36 (36.1%) considered this inappropriate. CONCLUSION: Our findings show that despite generally poor outcomes for older patients undergoing CPR, many emergency clinicians do not consider these attempts at resuscitation to be inappropriate. A professional and societal debate is urgently needed to ensure that first we do not harm older patients by futile CPR attempts. J Am Geriatr Soc 68:39–45, 201