Magnetic resonance imaging of the upper airway in patients with quadriplegia and obstructive sleep apnea.

The aim of this study was to investigate upper airway anatomy in quadriplegics with obstructive sleep apnea. Fifty subjects were recruited from three hospitals in Australia: people with quadriplegia due to spinal cord injury and obstructive sleep apnea (n = 11), able-bodied people with obstructive sleep apnea (n = 18), and healthy, able-bodied controls (n = 19). All underwent 3-Tesla magnetic resonance imaging of their upper airway. A subgroup (n = 34) received a topical vasoconstrictor, phenylephrine and post-phenylephrine magnetic resonance imaging. Mixed-model analysis indicated no significant differences in total airway lumen volume between the three groups (P = 0.086). Spinal cord injury-obstructive sleep apnea subjects had a significantly larger volume of soft palate (P = 0.020) and retroglossal lateral pharyngeal walls (P = 0.043) than able-bodied controls. Able-bodied-obstructive sleep apnea subjects had a smaller mandible volume than spinal cord injury-obstructive sleep apnea subjects and able-bodied control subjects (P = 0.036). No differences were seen in airway length between groups when controlling for height (P = 0.055). There was a marginal increase in velopharyngeal volume across groups post-phenylephrine (P = 0.050), and post hoc testing indicated the difference was confined to the able-bodied-obstructive sleep apnea group (P < 0.001). No other upper airway structures showed significant changes with phenylephrine administration. In conclusion, people with obstructive sleep apnea and quadriplegia do not have a structurally smaller airway than able-bodied subjects. They did, however, have greater volumes of soft palate and lateral pharyngeal walls, possibly due to greater neck fat deposition. The acute response to upper airway topical vasoconstriction was not enhanced in those with obstructive sleep apnea and quadriplegia. Changes in upper airway anatomy likely contribute to the high incidence in obstructive sleep apnea in quadriplegic subjects.

Comparison of diurnal blood pressure and urine production between people with and without chronic spinal cord injury.

STUDY DESIGN: Observational study. OBJECTIVES: To quantify diurnal blood pressure (BP) patterns and nocturnal hypertension and to measure diurnal urine production in people with chronic spinal cord injury (SCI), compared with controls without SCI. SETTING: Chronic SCI population in the community in Victoria, Australia. METHODS: Participants were recruited by advertisement, and sustained SCI at least a year prior or were healthy able-bodied volunteers. Participants underwent ambulatory BP monitoring (ABPM), measurement of urine production, and completed questionnaires regarding orthostatic symptoms. Comparisons were made between participants with tetraplegia or paraplegia and able-bodied controls. Participants with night:day systolic BP < 90% were classified as dippers, 90-100% as nondippers, and >100% as reverse dippers. RESULTS: Groups with tetraplegia (n = 51) and paraplegia (n = 33) were older (42.1 ± 15 and 41.1 ± 15 vs. 32.4 ± 13 years, mean ± s.d.) and had a higher prevalence of males (88 and 85% vs. 60%) than controls (n = 52). The average BP was 110.8 ± 1.5/64.4 ± 1.2 mmHg, 119.4 ± 2.1/69.8 ± 1.5 mmHg, and 118.1 ± 1.4/69.8 ± 1.0 mmHg in tetraplegia, paraplegia, and controls, respectively. Of participants with tetraplegia, paraplegia and controls, reverse dipping was observed in 45, 13, and 2% (p < 0.001), while nocturnal hypertension was observed in 13, 23, and 18%, respectively (p = 0.48). A reduction in nocturnal urine flow rate compared with the day was observed in paraplegia and controls, but not tetraplegia. CONCLUSIONS: Similar to the effects of acute SCI, chronic SCI, specifically tetraplegia, also causes isolated nocturnal hypertension, reverse dipping, orthostatic intolerance, and nocturnal polyuria. Cardiovascular risk management and assessment of orthostatic symptoms should include ABPM.

Effect of singing on respiratory function, voice, and mood after quadriplegia: a randomized controlled trial.

OBJECTIVE: To explore the effects of singing training on respiratory function, voice, mood, and quality of life for people with quadriplegia. DESIGN: Randomized controlled trial. SETTING: Large, university-affiliated public hospital, Victoria, Australia. PARTICIPANTS: Participants (N=24) with chronic quadriplegia (C4-8, American Spinal Injury Association grades A and B). INTERVENTIONS: The experimental group (n=13) received group singing training 3 times weekly for 12 weeks. The control group (n=11) received group music appreciation and relaxation for 12 weeks. Assessments were conducted pre, mid-, immediately post-, and 6-months postintervention. MAIN OUTCOME MEASURES: Standard respiratory function testing, surface electromyographic activity from accessory respiratory muscles, sound pressure levels during vocal tasks, assessments of voice quality (Perceptual Voice Profile, Multidimensional Voice Profile), and Voice Handicap Index, Profile of Mood States, and Assessment of Quality of Life instruments. RESULTS: The singing group increased projected speech intensity (P=.028) and maximum phonation length (P=.007) significantly more than the control group. Trends for improvements in respiratory function, muscle strength, and recruitment were also evident for the singing group. These effects were limited by small sample sizes with large intersubject variability. Both groups demonstrated an improvement in mood (P=.002), which was maintained in the music appreciation and relaxation group after 6 months (P=.017). CONCLUSIONS: Group music therapy can have a positive effect on not only physical outcomes, but also can improve mood, energy, social participation, and quality of life for an at-risk population, such as those with quadriplegia. Specific singing therapy can augment these general improvements by improving vocal intensity.

Consistent and low is the only way to go: A polynomial regression approach to the effect of abusive supervision inconsistency.

The literature on abusive supervision largely presumes that employees respond to abuse in a relatively straightforward way: When abuse is present, outcomes are unfavorable, and when abuse is absent, outcomes are favorable (or, at least less unfavorable). Yet despite the recognition that abusive supervision can vary over time, little consideration has been given to how past experiences of abuse may impact the ways employees react to it (or, its absence) in the present. This is a notable oversight, as it is widely acknowledged that past experiences create a context against which experiences in the present are compared. By applying a temporal lens to the experience of abusive supervision, we identify abusive supervision inconsistency as a phenomenon that may have different outcomes than would otherwise be predicted by the current consensus in this literature. We draw from theories on time and stress appraisal to develop a model that explains when, why, and for which employees, inconsistent abusive supervision may have negative outcomes (specifically, identifying anxiety as a proximal outcome of abusive supervision inconsistency that has downstream effects on turnover intentions). Moreover, the aforementioned theoretical perspectives dovetail in identifying employee workplace status as a moderator that may buffer employees from the stressful consequences of inconsistent abusive supervision. We test our model using two experience sampling studies with polynomial regression and response surface analyses. Our research makes important theoretical and practical contributions to the abusive supervision literature, as well as the literature on time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Relationships between objective sleep indices and symptoms in a community sample of people with tetraplegia.

OBJECTIVE: To examine the relationships between injury severity, quality of life, sleep symptoms, objectively measured sleep, and sleep disorders in chronic tetraplegia. DESIGN: Cross-sectional survey. SETTING: Community. PARTICIPANTS: People with tetraplegia (N=78; 59 men, 35 with motor and sensory complete tetraplegia; mean age ± SD, 43±12.1; age range 18-70y), living in the state of Victoria, Australia, who were not currently being treated for sleep disorders and who completed both questionnaires and sleep studies comprised the study cohort. INTERVENTION: Questionnaire battery mailed to potential participants. Returned questionnaires were followed with full, home-based polysomnography. MAIN OUTCOME MEASURES: Demographics and questionnaire responses. RESULTS: Quality of life (Assessment of Quality of Life instrument) was worse in the group with complete lesions compared with incomplete lesions (P=.001; median=16; interquartile range, 9 vs 12 [12]), and the Apnea-Hypopnea Index was higher (P=.002; interquartile range, 32.0 [25.2] vs 13.2 [24.8]). Ninety-one percent of those with complete lesions had obstructive sleep apnea (Apnea-Hypopnea Index >10) versus 55.8% of those with incomplete tetraplegia. No effect of lesion level on the Apnea-Hypopnea Index was observed (r=-.04, P=.73). In the complete group, the time taken from sleep onset until the first rapid eye movement sleep period was significantly delayed at over 2 hours. Multiple regression analyses showed substantially stronger relationships between daytime sleep complaints and abnormalities observed in the sleep study in those with complete lesions. CONCLUSIONS: Obstructive sleep apnea is a major problem, particularly in those with complete tetraplegia, and this single comorbidity is associated with reduced quality of life. In those with incomplete cervical lesions, the relationships between sleepiness, other sleep symptoms, and polysomnography indices are less precise.

Unbalanced, Unfair, Unhappy, or Unable? Theoretical Integration of Multiple Processes Underlying the Leader Mistreatment-Employee CWB Relationship with Meta-Analytic Methods.

Although a litany of theoretical accounts exists to explain why mistreated employees engage in counterproductive work behaviors (CWBs), little is known about whether these mechanisms are complementary or mutually exclusive, or the effect of context on their explanatory strength. To address these gaps, this meta-analytic investigation tests four theoretically-derived mechanisms simultaneously to explain the robust relationship between leader mistreatment and employee CWB: (1) a social exchange perspective, which argues that mistreated employees engage in negative reciprocal behaviors to counterbalance experienced mistreatment; (2) a justice perspective, whereby mistreated employees experience moral outrage and engage in retributive behaviors against the organization and its members; (3) a stressor-emotion perspective, which suggests that mistreated employees engage in CWBs to cope with their negative affect; and (4) a self-regulatory perspective, which proposes that mistreated employees are simply unable to inhibit undesirable behaviors. Moreover, we also examine whether the above model holds across cultures that vary on power distance. Our meta-analytic structural equation model demonstrated that all but the justice mechanism significantly mediated the relationship between leader mistreatment and employee CWBs, with negative affect emerging as the strongest explanatory mechanism in both high and low power distance cultures. Given these surprising results, as the stressor-emotion perspective is less frequently invoked in the literature, this paper highlights not only the importance of investigating multiple mechanisms together when examining the leader mistreatment-employee CWB relationship, but also the need to develop more nuanced theorizing about these mechanisms, particularly for negative affect.

Can two wrongs make a right? The buffering effect of retaliation on subordinate well-being following abusive supervision.

Subordinates who are abused by a supervisor tend to experience violated perceptions of interpersonal justice and deteriorated well-being. One way in which they may seek to cope with these consequences is by engaging in retaliatory behaviors intended to "get back" at their supervisor and even the score. Based on research suggesting that acts of retaliation can restore perceptions of justice, we propose a model whereby retaliation alleviates the effect of abusive supervision on subordinate well-being by restoring subordinates' interpersonal justice perceptions. In two studies, using multiwave (Study 1) and time-lagged (Study 2) designs, we found general support for our predictions, even when controlling for the alternative mechanism of victim identity and subordinates' baseline well-being. These results suggest that retaliation reduces the harmful consequences of supervisory abuse on well-being not only in the short term but also in the long run. Theoretical and practical implications surrounding this increased understanding of the effectiveness of retaliation as a strategy for coping with the effects of abusive supervision over time are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Assessment of breathing patterns and respiratory muscle recruitment during singing and speech in quadriplegia.

OBJECTIVES: To explore how respiratory impairment after cervical spinal cord injury affects vocal function, and to explore muscle recruitment strategies used during vocal tasks after quadriplegia. It was hypothesized that to achieve the increased respiratory support required for singing and loud speech, people with quadriplegia use different patterns of muscle recruitment and control strategies compared with control subjects without spinal cord injury. DESIGN: Matched, parallel-group design. SETTING: Large university-affiliated public hospital. PARTICIPANTS: Consenting participants with motor-complete C5-7 quadriplegia (n=6) and able-bodied age-matched controls (n=6) were assessed on physiologic and voice measures during vocal tasks. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Standard respiratory function testing, surface electromyographic activity from accessory respiratory muscles, sound pressure levels during vocal tasks, the Voice Handicap Index, and the Perceptual Voice Profile. RESULTS: The group with quadriplegia had a reduced lung capacity (vital capacity, 71% vs 102% of predicted; P=.028), more perceived voice problems (Voice Handicap Index score, 22.5 vs 6.5; P=.046), and greater recruitment of accessory respiratory muscles during both loud and soft volumes (P=.028) than the able-bodied controls. The group with quadriplegia also demonstrated higher accessory muscle activation in changing from soft to loud speech (P=.028). CONCLUSIONS: People with quadriplegia have impaired vocal ability and use different muscle recruitment strategies during speech than the able-bodied. These findings will enable us to target specific measurements of respiratory physiology for assessing functional improvements in response to formal therapeutic singing training.

Transcutaneous measurement of carbon dioxide tension during extended monitoring: evaluation of accuracy and stability, and an algorithm for correcting calibration drift.

BACKGROUND: When polysomnography is indicated in a patient with a presumed sleep disorder, continuous monitoring of arterial carbon dioxide tension (P(aCO(2))) is desirable, especially if nocturnal hypoventilation is suspected. Transcutaneous CO(2) monitors (P(tcCO(2))) provide a noninvasive correlate of P(aCO(2)), but their accuracy and stability over extended monitoring have been considered inadequate for the diagnosis of hypoventilation. We examined the stability and accuracy of P(tcCO(2)) measurements and the performance of a previously described linear interpolation technique designed to correct for calibration drift. METHODS: We compared the P(tcCO(2)) values from 2 TINA TCM-3 monitors to P(aCO(2)) values from arterial blood samples obtained at the beginning, every 15 min of the first hour, and then hourly over 8 hours of monitoring in 6 hemodynamically stable, male, intensive care patients (mean age 46 ± 17 y). RESULTS: Time had a significant (P = .002) linear effect on the P(tcCO(2))-P(aCO(2)) difference, suggesting calibration drift over the monitoring period. We found no differences between monitor type or interaction between time and monitor type. For the 2 monitors the uncorrected bias was 3.6 mm Hg and the limits of agreement were -5.1 to 12.3 mm Hg. Our linear interpolation algorithm improved the bias and limits of agreement to 0.4 and -5.5 to 6.4 mm Hg, respectively. CONCLUSIONS: Following stabilization and correction for both offset and drift, P(tcCO(2)) tracks P(aCO(2)) with minimal residual bias over 8 hours of monitoring. Should future research confirm these findings, then interpolated P(tcCO(2)) may have an increased role in detecting sleep hypoventilation and assessing the efficacy of treatment.

Subordinate poor performance as a stressor on leader well-being: The mediating role of abusive supervision and the moderating role of motives for abuse.

Drawing upon Stress-as-Offense-to-Self theory, we develop a moderated mediation model whereby subordinate poor performance and leader well-being is linked by abusive supervision and this mediated relationship is further moderated by leaders' motives for abuse. Specifically, we posit that higher performance promotion motives will attenuate, whereas higher injury motives will exacerbate the relationship between abusive supervision and leader emotional exhaustion, due to their differential implications for leaders' ability to see themselves in a positive light. In a pilot study, we first examined and found support for the theorized mediation chain in a multiwave field study of organizational leaders (N = 71). In Study 1, we conducted a multiwave and multisource field study of leader-follower dyads (N = 274), which supported our predictions that the indirect effect between subordinate poor performance and leader emotional exhaustion via abusive supervision was strengthened for leaders higher on injury motives. In Study 2, we undertook a 2-week daily diary study with leaders (N = 129) to hone in on the latter half of our model, focusing on within-person dynamics linking abusive supervision and leader well-being and the moderating role of leader motives for abuse. Although the within-person relationship between abusive supervision and emotional exhaustion was positive within a given day across leaders, the lagged within-person relationship between abusive supervision and emotional exhaustion unfolded differently for leaders higher versus lower on injury motives. Namely, abusive supervision had a lingering detrimental effect on leader emotional exhaustion among leaders higher on injury motives. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

When does self-esteem relate to deviant behavior? The role of contingencies of self-worth.

Researchers have assumed that low self-esteem predicts deviance, but empirical results have been mixed. This article draws upon recent theoretical developments regarding contingencies of self-worth to clarify the self-esteem/deviance relation. It was predicted that self-esteem level would relate to deviance only when self-esteem was not contingent on workplace performance. In this manner, contingent self-esteem is a boundary condition for self-consistency/behavioral plasticity theory predictions. Using multisource data collected from 123 employees over 6 months, the authors examined the interaction between level (high/low) and type (contingent/noncontingent) of self-esteem in predicting workplace deviance. Results support the hypothesized moderating effects of contingent self-esteem; implications for self-esteem theories are discussed.

Faking and the validity of conscientiousness: a Monte Carlo investigation.

The article reports the findings from a Monte Carlo investigation examining the impact of faking on the criterion-related validity of Conscientiousness for predicting supervisory ratings of job performance. Based on a review of faking literature, 6 parameters were manipulated in order to model 4,500 distinct faking conditions (5 [magnitude] x 5 [proportion] x 4 [variability] x 3 [faking-Conscientiousness relationship] x 3 [faking-performance relationship] x 5 [selection ratio]). Overall, the results indicated that validity change is significantly affected by all 6 faking parameters, with the relationship between faking and performance, the proportion of fakers in the sample, and the magnitude of faking having the strongest effect on validity change. Additionally, the association between several of the parameters and changes in criterion-related validity was conditional on the faking-performance relationship. The results are discussed in terms of their practical and theoretical implications for using personality testing for employee selection.

The development and validation of the Workplace Ostracism Scale.

This article outlines the development of a 10-item measure of workplace ostracism. Using 6 samples (including multisource and multiwave data), the authors developed a reliable scale with a unidimensional factor structure that replicated across 4 separate samples. The scale possessed both convergent and discriminant validity, and criterion-related validity was demonstrated through the scale's relation with basic needs, well-being, job attitudes, job performance, and withdrawal. Overall, the present study suggests that the Workplace Ostracism Scale is a reliable and valid measure and that the workplace ostracism construct has important implications for both individuals and organizations.

The dimensions and mechanisms of mindfulness in regulating aggressive behaviors.

On the basis of the notion that the ability to exert self-control is critical to the regulation of aggressive behaviors, we suggest that mindfulness, an aspect of the self-control process, plays a key role in curbing workplace aggression. In particular, we note the conceptual and empirical distinctions between dimensions of mindfulness (i.e., mindful awareness and mindful acceptance) and investigate their respective abilities to regulate workplace aggression. In an experimental study (Study 1), a multiwave field study (Study 2a), and a daily diary study (Study 2b), we established that the awareness dimension, rather than the acceptance dimension, of mindfulness plays a more critical role in attenuating the association between hostility and aggression. In a second multiwave field study (Study 3), we found that mindful awareness moderates the association between hostility and aggression by reducing the extent to which individuals use dysfunctional emotion regulation strategies (i.e., surface acting), rather than by reducing the extent to which individuals engage in dysfunctional thought processes (i.e., rumination). The findings are discussed in terms of the implications of differentiating the dimensions and mechanisms of mindfulness for regulating workplace aggression. (PsycINFO Database Record

Facilitators and Barriers to International Collaboration in Spinal Cord Injury: Results from a Survey of Clinicians and Researchers.

International collaboration in spinal cord injury (SCI) research is necessary to overcome the challenges often encountered by clinicians and researchers, including participant recruitment, high cost, and the need for specialized expertise. However, international collaboration poses its own obstacles. The objective of this study was to conduct an international online survey to assess barriers and facilitators to international SCI clinical research, potential initiatives to facilitate future collaborations, and the use of SCI-specific data sets and standards. Results were analyzed using descriptive statistics. Of 364 total respondents, 213 completed the survey, with the majority of these participants based in North America (38%), Asia (22%), Europe (18%), and Oceania (16%). Over half had more than 10 years of experience in SCI research or clinical practice (57%) and 60% had previous experience with international collaborations. Funding was identified as a top barrier (82%), a facilitator (93%), and a proposed future initiative (97%). Communication and technology were also identified as strong facilitators and proposed future initiatives. The International Standards for Neurological Classification of SCI were used by 69% of participants, the International Standards to document remaining Autonomic Function after SCI by 13% of participants, and the International SCI Data Sets by 45% of participants. As the need for international collaborations in SCI research increases, it is important to identify how clinicians and researchers can be supported by SCI consumer and professional organizations, funders, and networks. Furthermore, unique solutions to overcome modifiable barriers and creation of new facilitators are also needed.

Moving beyond assumptions of deviance: The reconceptualization and measurement of workplace gossip.

Despite decades of research from other academic fields arguing that gossip is an important and potentially functional behavior, organizational research has largely assumed that gossip is malicious talk. This has resulted in the proliferation of gossip items in deviance scales, effectively subsuming workplace gossip research into deviance research. In this paper, the authors argue that organizational research has traditionally considered only a very narrow subset of workplace gossip, focusing almost exclusively on extreme negative cases which are not reflective of typical workplace gossip behavior. Instead of being primarily malicious, typical workplace gossip can be either positive or negative in nature and may serve important functions. It is therefore recommended that workplace gossip be studied on its own, independent of deviance. To facilitate this, the authors reconceptualize the workplace gossip construct and then develop a series of general-purpose English- and Chinese-language workplace gossip scales. Using 8 samples (including qualitative, multisource, multiwave, and multicultural data), the authors demonstrate the construct validity, reliability, cross-cultural measurement invariance, and acceptable psychometric properties of the workplace gossip scales. Relationships are demonstrated between workplace gossip and a variety of other organizational variables and processes, including uncertainty, emotion validation, self-esteem, norm enforcement, networking, influence, organizational justice, performance, deviance, and turnover. Future directions in workplace gossip research are discussed. (PsycINFO Database Record

Proactive personality and the successful job search: a field investigation with college graduates.

The current article tests a model of proactive personality and job search success with a sample of 180 graduating college students. Using structural equation modeling, the authors tested a theoretical model that specified the relations among proactive personality, job search self-efficacy, job search behaviors, job search effort, and job search outcomes. Job seekers were surveyed at 2 separate points in time, once 3-4 months prior to graduation and once 2-3 months following graduation. The results suggest that proactive personality (a) significantly influenced the success of college graduates' job search, (b) was partially mediated through job search self-efficacy and job search behavior, and (c) was independent of self-esteem and conscientiousness. The findings are discussed in terms of their general implications for understanding the nature of the process through which distal personality factors, such as proactive personality, affect the nature and success of an individual's job search.

Inorganic arsenic in drinking water and bladder cancer: a meta-analysis for dose-response assessment.

Most arsenic cancer risk assessments have been based solely on epidemiological studies to characterize the dose-response relationship for arsenic-associated cancer and to perform risk calculations. However, current epidemiological evidence is too inconsistent and fraught with uncertainty regarding arsenic exposure to provide reliable estimates. This makes it hard to draw a firm conclusion about the shape and slope of the dose-response relationship from individual studies. Meta-analysis is a statistical approach to combining results across studies and offers expanded opportunities for obtaining an improved dose-response relationship. In this study, a meta-analysis of arsenic studies was conducted by combining seven epidemiological studies from different regions to get an overall dose-response relationship between the amount of arsenic intake and the excess probability of bladder cancer. Both the fixed-effect and random-effect models were used to calculate the averaged coefficient of the linear-logistic regression model. A homogeneity test was also conducted. The final product of this research is an aggregated dose-response model in the range of empirical observation of arsenic. Considering the most recent arsenic MCL (maximum contaminant level, i.e. 10microg/L), the associated bladder cancer risk (lifetime excess probability) at this MCL is 2.29 x 10-5.