Predicting Turnover: The Moderating Effect of Functional Climates on Emotional Exhaustion and Work Attitudes.

This study draws on social exchange theory and examines the relationships between emotional exhaustion and mental health provider work attitudes and turnover, and the moderating effect of functional psychological climates. Data were analyzed using multilevel structural equation modeling in a sample of 311 mental health providers from 49 community mental health programs. Results revealed that emotional exhaustion was negatively related to work attitudes, and the relationship was moderated by functional climates characterized by high levels of cooperation, growth and advancement opportunities, and role clarity. Specifically, the relationship between emotional exhaustion and work attitudes was attenuated for providers working in programs with a more functional psychological climate. Lower work attitudes significantly predicted higher clinician turnover. Results are discussed as they relate to improving climates and enhancing mental health provider and organizational well-being. PMID: 31127420 [PubMed - as supplied by publisher]
Source: Community Mental Health Journal - Category: Psychiatry Authors: Tags: Community Ment Health J Source Type: research

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Authors: Cowan TL Abstract Background: Negative attitudes toward dementia can delay care and diagnosis, increase social isolation, and limit recognition of the positive attributes of people living with dementia. The purpose of this project was to explore whether Dementia Friends sessions affected attitudes toward people living with dementia. Dementia Friends is a program which includes basic information about dementia that was developed by the Alzheimer's Society in the United Kingdom and is now offered in the United States. Participants: For this study, 101 adults ages 18 years and older were recruited from l...
Source: Gerontology and Geriatrics Education - Category: Geriatrics Tags: Gerontol Geriatr Educ Source Type: research
Objectives: To propose a previous implant fractures (PIFs) classification system with good interobserver reliability. Design: Retrospective classification. Setting: Four academic medical centers. Patients/Participants: A retrospective review of PIFs treated at 4 academic medical centers over 10 years was performed. Data collected included initial implant and PIF radiographs. There were 103 PIFs in 96 patients during the study period. Seventy-three (70.9%) were about plate/screw (PS) constructs and 30 (29.1%) were about intramedullary (IM) devices. Intervention: Assignment of PIF classification. Main Outcome ...
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Conclusion: Stability of 2-part intertrochanteric femur fractures is dependent on the fixation device. These fractures are not necessarily stable when treated with a sliding hip screw as 26% treated with this method collapsed greater than 10 mm and 17% more than 20 mm. Dual screw intramedullary nail fixation seems to be most effective to maintain stability for patients with this fracture pattern. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Conclusions: The use of the Synthes VA-LCP is a viable option in distal femoral fractures and has an acceptable failure rate and reoperation to promote union rate. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Conclusions: In contrast to a study conducted by Sun et al, in which there was a statistical difference in knee pain between the SP and IP surgical approaches, we did not detect any statistical or clinical differences in knee pain between the SP and IP surgical approaches among patients with greater than 12 months of follow-up. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Objectives: To identify the incidence and risk factors for development of tibial plafond nonunion. Design: Retrospective comparative study. Setting: Two Level 1 academic trauma centers. Patients/Participants: Seven hundred forty tibial plafond fractures (OTA/AO 43B3 and 43C) treated January 2006 to December 2015. Intervention: Open reduction and internal fixation. Main Outcome Measurement: Nonunion. Results: Five hundred eighteen patients with a mean age of 43 years (range, 18–81 years) and mean follow-up of 27 months (range, 12–115 months) were involved. Seventy-two patients (72/518, 14%) w...
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Conclusions: The articular surface is a significantly more accurate visual landmark for translational reduction of the syndesmosis. This is potentially explained by the larger differences in the fibula and tibial depth at the incisura versus the articular surface.
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Conclusions: This study was able to demonstrate that the syndesmotic view is more sensitive than the mortise view in detecting syndesmotic instability in a cadaveric model. It is particularly helpful to uncover instability secondary to an incomplete syndesmosis injury requiring fixation.
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Objectives: To explore what effect a dynamic fixation construct would have on the final reduction of the syndesmosis. Methods: Syndesmotic ligaments were sectioned in 10 cadaveric specimens. The syndesmosis was intentionally malreduced with a clamp, and the distance from the anterior edge of the fibula to the anterior incisura of the tibia was measured to quantify the sagittal syndesmotic displacement (SSD). A 3.5-mm quadricortical screw was then placed, the clamp was removed, and the SSD measured. The clamp was then replaced, and a suture-button construct (Knotless Tightrope; Arthrex Inc, Naples, FL) was then placed ...
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
Objective: To compare the reproducibility and prognostic capacity of 2 commonly used ankle fracture classifications to the stability-based classification. Methods: One hundred ninety-three consecutive rotational-type ankle fractures treated during a year at our institution in patients older than 18 years were retrospectively analyzed. Pilon and pathologic fractures were excluded. The fractures were treated by attending physicians who were unaware of the stability-based classification system. Three observers classified injury radiographs using the Lauge-Hansen, Weber/AO, and stability-based classifications systems. Rep...
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
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