872 research outputs found

    Setting high expectations is not enough: linkages between expectation climate strength, trust, and employee performance

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    Drawing on Climate Theory and Social Exchange Theory, we examine whether and how the strength of the expectation climate, defined as the degree of agreement amongst job incumbents on what is expected from them, affects their job performance. To explain this relationship, we utilize mediating trust-in-the-organization effects as an explanatory avenue. In a time-lagged data sample of 568 public service employees, whose job performance is rated by their 242 line managers, we apply multilevel modelling. We employed stratified random sampling techniques across 75 job functions in a large, public sector organization in Belgium. Our analysis provides support for the argument that expectation climate strength via mediating trust-in-the-organization effects impacts positively on the relationship between employee expectations and performance. Specifically, the significant association of the expectation climate strength with trust suggests that the perceived consensus about the expectations among different job incumbents demonstrates an organization’s trustworthiness and reliability to pursue intentions that are deemed favorable for employees. We conjecture that expectation climate strength breeds trust which strengthens employees’ job performance. HRM professionals in general, and line managers in particular, should heed our advice and carefully manage their tools and practices in an effort to signal compatible expectancies to different job incumbents in the same or similar roles. Our results shed new light on the mechanisms through which the strength of collective expectations impacts employee outcomes

    Proprioceptive changes impair balance control in individuals with chronic obstructive pulmonary disease

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    Copyright @ 2013 Janssens et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Introduction: Balance deficits are identified as important risk factors for falling in individuals with chronic obstructive pulmonary disease (COPD). However, the specific use of proprioception, which is of primary importance during balance control, has not been studied in individuals with COPD. The objective was to determine the specific proprioceptive control strategy during postural balance in individuals with COPD and healthy controls, and to assess whether this was related to inspiratory muscle weakness. Methods: Center of pressure displacement was determined in 20 individuals with COPD and 20 age/gender-matched controls during upright stance on an unstable support surface without vision. Ankle and back muscle vibration were applied to evaluate the relative contribution of different proprioceptive signals used in postural control. Results: Individuals with COPD showed an increased anterior-posterior body sway during upright stance (p=0.037). Compared to controls, individuals with COPD showed an increased posterior body sway during ankle muscle vibration (p=0.047), decreased anterior body sway during back muscle vibration (p=0.025), and increased posterior body sway during simultaneous ankle-muscle vibration (p=0.002). Individuals with COPD with the weakest inspiratory muscles showed the greatest reliance on ankle muscle input when compared to the stronger individuals with COPD (p=0.037). Conclusions: Individuals with COPD, especially those with inspiratory muscle weakness, increased their reliance on ankle muscle proprioceptive signals and decreased their reliance on back muscle proprioceptive signals during balance control, resulting in a decreased postural stability compared to healthy controls. These proprioceptive changes may be due to an impaired postural contribution of the inspiratory muscles to trunk stability. Further research is required to determine whether interventions such as proprioceptive training and inspiratory muscle training improve postural balance and reduce the fall risk in individuals with COPD.This work was supported by the Research Foundation – Flanders (FWO) grants 1.5.104.03, G.0674.09, G.0598.09N and G.0871.13N

    Impaired Postural Control Reduces Sit-to-Stand-to-Sit Performance in Individuals with Chronic Obstructive Pulmonary Disease

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    Abstract Background: Functional activities, such as the sit-to-stand-to-sit (STSTS) task, are often impaired in individuals with chronic obstructive pulmonary disease (COPD). The STSTS task places a high demand on the postural control system, which has been shown to be impaired in individuals with COPD. It remains unknown whether postural control deficits contribute to the decreased STSTS performance in individuals with COPD. Methods: Center of pressure displacement was determined in 18 individuals with COPD and 18 age/gender-matched controls during five consecutive STSTS movements with vision occluded. The total duration, as well as the duration of each sit, sit-to-stand, stand and stand-to-sit phase was recorded. Results: Individuals with COPD needed significantly more time to perform five consecutive STSTS movements compared to healthy controls (1966 vs. 1364 seconds, respectively; p = 0.001). The COPD group exhibited a significantly longer stand phase (p = 0.028) and stand-to-sit phase (p = 0.001) compared to the control group. In contrast, the duration of the sit phase (p = 0.766) and sit-to-stand phase (p = 0.999) was not different between groups. Conclusions: Compared to healthy individuals, individuals with COPD needed significantly more time to complete those phases of the STSTS task that require the greatest postural control. These findings support the proposition that suboptimal postural control is an important contributor to the decreased STSTS performance in individuals with COPD

    Eight-step method to build the clinical content of an evidence-based care pathway: the case for COPD exacerbation

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    Abstract Background Optimization of the clinical care process by integration of evidence-based knowledge is one of the active components in care pathways. When studying the impact of a care pathway by using a cluster-randomized design, standardization of the care pathway intervention is crucial. This methodology paper describes the development of the clinical content of an evidence-based care pathway for in-hospital management of chronic obstructive pulmonary disease (COPD) exacerbation in the context of a cluster-randomized controlled trial (cRCT) on care pathway effectiveness. Methods The clinical content of a care pathway for COPD exacerbation was developed based on recognized process design and guideline development methods. Subsequently, based on the COPD case study, a generalized eight-step method was designed to support the development of the clinical content of an evidence-based care pathway. Results A set of 38 evidence-based key interventions and a set of 24 process and 15 outcome indicators were developed in eight different steps. Nine Belgian multidisciplinary teams piloted both the set of key interventions and indicators. The key intervention set was judged by the teams as being valid and clinically applicable. In addition, the pilot study showed that the indicators were feasible for the involved clinicians and patients. Conclusions The set of 38 key interventions and the set of process and outcome indicators were found to be appropriate for the development and standardization of the clinical content of the COPD care pathway in the context of a cRCT on pathway effectiveness. The developed eight-step method may facilitate multidisciplinary teams caring for other patient populations in designing the clinical content of their future care pathways.</p

    Leader-employee congruence of expected contributions in the employee-organization relationship

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    Employees' expected contributions can be incongruent with those of their leader. We examine the congruence effect of leaders' and employees' expected contributions on job satisfaction. Results of cross-level polynomial regressions on 947 employees and 224 leaders support the congruence effect. When expected contributions are congruent, employees are more satisfied with their job. Our findings suggest that employees enjoy high challenges, as long as these challenges are in harmony with the expected contributions of their leaders. Employees are less satisfied with their jobs both when their expected contributions were higher than their leaders' and when their expected contributions were lower than those of their leaders. Beyond the relevance of having high expected contributions, the findings highlight the crucial role played by the congruence of expected contributions of leaders and employees

    Inspiratory muscle training improves breathing pattern during exercise in COPD patients (letter).

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    The addition of IMT to a PR programme for selected COPD patients changes breathing pattern during exercise

    COPD in young patients: A pre-specified analysis of the four-year trial of tiotropium (UPLIFT)

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    SummaryWhilst recent large-scale studies have provided much evidence on the natural history and therapeutic response in patients with chronic obstructive pulmonary disease (COPD), relatively little is known about the effect in younger patients.We report a pre-specified post-hoc analysis of 356 patients with COPD ≤ 50 years old from the four year randomised, double blind placebo controlled Understanding Potential Long Term Impact on Function with Tiotropium (UPLIFT) trial. Inclusion criteria included a post-bronchodilator forced expiratory volume in 1 s (FEV1) of ≤70%, FEV1/FVC < 0.70, age ≥40 years, and smoking history of ≥10 pack years.Younger patients had a mean FEV1 of 1.24 L (39% predicted) and an impaired health-related quality of life (St. George’s Respiratory Questionnaire (SGRQ)) compared to the entire UPLIFT population. There were 40.2% women and 51.1% current smokers in the younger age group. Tiotropium was associated with a sustained improvement in spirometry and SGRQ. Mean decline in post-bronchodilator FEV1 was 58 ml/year (placebo) vs. 38 ml/year (tiotropium) (p = 0.01). Corresponding values for pre-bronchodilator FEV1 were 41 ml/year (placebo) compared with 34 ml/year (tiotropium) (p = 0.34). The hazard ratio (95%CI) for an exacerbation in the younger age group was 0.87(0.68, 1.13)). The rate of exacerbations was reduced by tiotropium (rate ratio (95%CI) = 0.73(0.56, 0.95)).Tiotropium resulted in sustained bronchodilation, improved quality of life, and a decreased exacerbation rate in younger patients. Tiotropium also resulted in a significant reduction in the decline in post-bronchodilator FEV1, suggesting possible disease modification by tiotropium in younger patients with COPD

    Institutional isomorphism, negativity bias and performance information use by politicians: A survey experiment

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    New Public Management popularized performance measurement in public organizations. Underlying performance measurement's popularity is the assumption that it injects performance information (PI) into decision-making, thus rationalizing the ensuing decisions. Despite its popularity, performance measurement is criticized. In part, this criticism results from the limited knowledge of the conditions under which PI is purposefully used by politicians. We conducted a survey experiment based on real PI with 1,240 politicians. We hypothesized that PI has a positive impact on performance information use (PIU) when PI is benchmarked with coercive, mimetic or normative pressures. Moreover, due to negativity bias we expected this positive impact to be stronger when PI signals low performance. We found that normative pressures had a positive impact on actual PIU while coercive pressures positively affected intended PIU. Negativity bias is only relevant when linked to coercive pressures and intended PIU for analysing the organization's finances
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