Application of End-Tidal CO2 Monitoring to ICU Management.

Waveform capnography is a noninvasive measurement of ventilation and perfusion commonly employed in the prehospital setting. It is easy to apply, and modern cardiac monitors are equipped with the necessary ports and capability to display results. Despite its ease of use, end-tidal CO2 monitoring has not yet achieved widespread adoption within the hospital setting. It is routinely used in the emergency department and by anesthesiologists, but its application could support ICU management in critically ill patients. Its use is routinely supported by multiple professional societies, and it has been recommended as a requirement in all cardiac arrests. Careful analysis of the waveform and expired carbon dioxide can guide therapy for patients experiencing respiratory emergencies, hemodynamic compromise, metabolic acidosis, and shock due to trauma, hypovolemia, or sepsis. Use of capnography throughout the hospital could improve patient outcomes and prevent unidentified deterioration.

Relationship-specific (dyadic) humility: How your humility predicts my psychological safety and performance.

A leader's expressed humility has a favorable influence on subordinates' job satisfaction, creativity, and performance. However, we know little about how humility affects one's same-level coworkers. Shifting focus away from leader's humility, we suggest that coworker humility can also produce positive effects but has a relationship-specific component. Some coworker relationships are characterized by greater expression of humility than others. Specifically, we hypothesize that when a coworker expresses a uniquely high degree of humility to another coworker (i.e., relationship-specific humility), the latter coworker experiences a uniquely high level of psychological safety (i.e., relationship-specific psychological safety), which in turn leads that coworker to perform better (i.e., relationship-specific performance). Pilot Study 1 (N = 155, in 32 teams, yielding 823 relationship-specific ratings) showed that humility has a substantial relationship-specific variance component, even in unacquainted teams. Pilot Study 2 (N = 180, in 39 teams, yielding 854 relationship-specific ratings) built on these results in a sample of moderately acquainted teams and showed that relationship-specific humility is associated with relationship-specific perceptions of performance. The Main Study (N = 133, in 32 well-acquainted work teams, yielding 555 relationship-specific ratings) tested our full model. It demonstrated that the association between relationship-specific humility and relationship-specific performance is mediated by relationship-specific psychological safety. We discuss how our findings advance humility research in the workplace by showing that a portion of humility expression is relationship-specific and stems from each employee's unique interaction with another specific person, and that such relationship-specific humility affects relationship-specific performance. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Systematic Review of Echocardiographic Parameters for the Screening of Pulmonary Hypertension: What Are the Odds?

Pulmonary hypertension (PH) is an insidious disease that often presents in late stages due to nonspecific signs and symptoms. Right heart catheterization (RHC) is the gold standard diagnostic test, and echocardiogram (ECHO) is the best screening tool. However, the strength of evidence and diagnostic utility of various echocardiographic parameters to screen for is not well elucidated. This systematic review (SR) is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Literature searches was performed for the period of January 1, 2016, to June 1, 2021, on seven databases. We included full-text studies with adult patients that used RHC for comparison and provided sensitivity and specificity results. Likelihood ratios (LRs) and diagnostic odds ratios (DORs) were calculated. Risk of bias was assessed using the Quality Assessment Tool for the Observational Cohort and Cross-Sectional Studies. We identified 102 studies, but only 14 satisfied our inclusion criteria. The most significant parameters identified for PH screening based on LRs are, in descending order, tricuspid regurgitation gradient peak >36mmHg, systolic pulmonary artery pressure >41mmHg, and tricuspid regurgitation velocity >2.9 m/s. There is strong correlation between LR and DOR for these parameters. This SR indicates the superiority of some ECHO parameters over others to aid in the screening and severity assessment of PH. Variables with low LR (-) ratios may help to prevent unnecessary invasive assessment for PH. Clinicians should utilize a multi-parameter approach when interpreting echocardiograms for PH assessment.

Motivation to lead: A meta-analysis and distal-proximal model of motivation and leadership.

To understand how motivation to lead (MTL) fits into the broader leadership literature, we present a meta-analytic review of MTL and test a Distal-Proximal Model of Motivation and Leadership. Using a database of 1,154 effect sizes from 100 primary studies, we found that the 3 types of MTL (affective-identity, social-normative, and noncalculative) had a unique pattern of antecedents and were only modestly correlated, indicating that MTL may be best operationalized as three separate motivational constructs instead of as one overarching construct. Further, the 3 MTL types were generally associated with individuals emerging as leaders, engaging in beneficial leadership behaviors (i.e., more transformational and transactional leadership, as well as less laissez faire leadership), and performing more effectively in leadership roles. Finally, meta-analytic path analysis demonstrated that the three MTL types partially explained the relationship between more distal predictors (i.e., gender, cognitive ability, the Big Five, past leader experience, and leader self-efficacy) and leadership emergence/effectiveness. Interestingly, we found that traits often viewed as beneficial for leadership (extraversion, conscientiousness, and openness) may have a darker side that is transmitted through MTL. Taken together, this study advances theory by clarifying the distinctiveness of the three MTL types, establishing MTL's relationship with leadership outcomes, and identifying MTL's role within the broader leadership domain. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The impact of leader moral humility on follower moral self-efficacy and behavior.

This study utilizes social-cognitive theory, humble leadership theory, and the behavioral ethics literature to theoretically develop the concept of leader moral humility and its effects on followers. Specifically, we propose a theoretical model wherein leader moral humility and follower implicit theories about morality interact to predict follower moral efficacy, which in turn increases follower prosocial behavior and decreases follower unethical behavior. We furthermore suggest that these effects are strongest when followers hold an incremental implicit theory of morality (i.e., believing that one's morality is malleable). We test and find support for our theoretical model using two multiwave studies with Eastern (Study 1) and Western (Study 2) samples. Furthermore, we demonstrate that leader moral humility predicts follower moral efficacy and moral behaviors above and beyond the effects of ethical leadership and leader general humility. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Exploring the affective impact, boundary conditions, and antecedents of leader humility.

In this article, the authors further develop the theory of leader humility by exploring the affective impact, a vital boundary condition, and the antecedents of leader humility. Specifically, they (a) theorize how leader humility can enhance followers' performance by increasing their relational energy and decreasing their emotional exhaustion, (b) test perceived leader power in the organization as an important boundary condition of leader humility effectiveness, and (c) establish leader's incremental theory of the self (i.e., growth mindset) and relational identity as important enablers of leader humility. Surveying 211 leader-follower dyads in a two-phase study (Study 1), we find that leader humility has a positive indirect effect on followers' task performance through increased follower relational energy and decreased emotional exhaustion. In addition, the effects of leader humility on followers' relational energy with the leader, emotional exhaustion, and task performance tend to be stronger when followers perceive more power in the leader. Study 2-a multiphase field study surveying 201 leader-follower dyads embedded in 85 teams-not only replicates the results found in Study 1 with more objective, multirater employee performance, but more importantly, establishes leader incremental theory of the self (or growth mindset; Dweck, 2010) and relational identity as important antecedents of leader humility. The authors discuss theoretical and practical implications and recommend directions for future research. (PsycINFO Database Record

Initiating and utilizing shared leadership in teams: The role of leader humility, team proactive personality, and team performance capability.

The present study was designed to produce novel theoretical insight regarding how leader humility and team member characteristics foster the conditions that promote shared leadership and when shared leadership relates to team effectiveness. Drawing on social information processing theory and adaptive leadership theory, we propose that leader humility facilitates shared leadership by promoting leadership-claiming and leadership-granting interactions among team members. We also apply dominance complementary theory to propose that team proactive personality strengthens the impact of leader humility on shared leadership. Finally, we predict that shared leadership will be most strongly related to team performance when team members have high levels of task-related competence. Using a sample composed of 62 Taiwanese professional work teams, we find support for our proposed hypothesized model. The theoretical and practical implications of these results for team leadership, humility, team composition, and shared leadership are discussed. (PsycINFO Database Record

Relational energy at work: Implications for job engagement and job performance.

Energy is emerging as a topic of importance to organizations, yet we have little understanding of how energy can be useful at an interpersonal level toward achieving workplace goals. We present the results of 4 studies aimed at developing, validating, and testing the relational energy construct. In Study 1, we report qualitative insights from 64 individuals about the experience and functioning of relational energy in the workplace. Study 2 draws from 3 employee samples to conduct exploratory and confirmatory factor analyses on a measure of relational energy, differentiating relational energy from related constructs. To test the predictive validity of the new relational energy scale, Study 3 comprises data from employees rating the level of relational energy they experienced during interactions with their leaders in a health services context. Results showed that relational energy employees experienced with their leaders at Time 1 predicted job engagement at Time 2 (1 month later), while controlling for the competing construct of perceived social support. Study 4 shows further differentiation of relational energy from leader-member exchange (LMX), replicates the positive relationship between relational energy (Time 1) and job engagement (Time 2), and shows that relational energy is positively associated with employee job performance (Time 3) through the mechanism of job engagement. We discuss the theoretical implications of our findings and highlight areas for future research.

Leader narcissism and follower outcomes: The counterbalancing effect of leader humility.

[Correction Notice: An Erratum for this article was reported in Vol 100(4) of Journal of Applied Psychology (see record 2015-29666-001). The last name of the second author was misspelled in the Online First version of the article. All versions of this article have been corrected.] In response to recent calls to theorize and examine how multiple leader characteristics may work together in their effects, the current research examines how leader narcissism and humility interact to predict perceived leader effectiveness and follower (i.e., direct-report) job engagement and performance. Although an examination of leaders who are narcissistic yet humble may seem oxymoronic and even paradoxical, researchers have suggested that seemingly contradictory personal attributes may exist simultaneously and may actually work together to produce positive outcomes. Results from survey data from followers and leaders working for a large health insurance organization showed that the interaction of leader narcissism and leader humility is associated with perceptions of leader effectiveness, follower job engagement, and subjective and objective follower job performance. Together, these results suggest that narcissistic leaders can have positive effects on followers when their narcissism is tempered by humility.