Organizational Change and Workplace Incivility: Mediated by Stress, Moderated by Emotional Exhaustion.

Modern organizations continuously undergo change processes. The focus of the organizations remains on the macro level, but the micro level (i.e., employee's perspective) is neglected. Using the conservation of resource theory (COR), this study examines the association between organizational change and workplace incivility. This study also proposes mediating and moderating mechanisms of stress and emotional exhaustion. The data were collected from 262 respondents working in public sector organizations in Pakistan using a time-lagged technique. The results proved that change significantly impacts workplace incivility. Moreover, stress mediates their relationship and emotional exhaustion moderates it. Furthermore, emotional exhaustion also moderates the stress-incivility relationship. Public sector organizations must focus on well-planned, inclusive, and adequately managed change processes to achieve the desired outcome; otherwise, adverse behaviors, including incivility, manifest. To the best of the authors' knowledge, the organizational change and incivility relationship has not been explored in the past. Additionally, their relationship with stress and emotional exhaustion also requires empirical investigation. This study also adds to the literature on the conservation of resource theory.

Comparison Of Vagal Maneuvers Vs Verapamil For Cardioversion Of Atrioventricular Nodal Reentrant Tachycardia.

BACKGROUND: Vagal Maneuver is an underutilized strategy for Cardioversion of Atrioventricular nodal reentrant tachycardia. The present study is an attempt to explore the effectiveness of this strategy. METHODS: This comparative cross-sectional study was performed at the Department of Cardiology MTI MMC Mardan from the first January 2017 to 31 December 2019. Patients with Palpitations and having documented AVNRT on ECG were selected for this study. Patients were divided into two groups, i.e., Group A and Group B through envelope method. Patients in Group A were subjected to vagal maneuvers like carotid sinus massage, and Valsalva methods. Patients in Group B received injection verapamil 5 mg. RESULTS: A sample size of 100 patients were enrolled. The mean age was 31 with 8.6SD. Male were 54% and females were 46%. The success rate of vagal maneuvers in group A was 36% (n=18), while in group B, it was 84% (n=42) for verapamil (36% vs 84%, p-value<0.001, highly significant). In group A, time for cardioversion in less than 2 minutes was 68%. While in group B, the time for cardioversion in less than two minutes was 12%. ( 68% vs 12%, p<0.001, highly significant).Cross over in Group A was 64% (n=32) to verapamil. While in group B, this was 6% (n=3) to DC shock and 14% (n=7) to vagal maneuvers (64% vs 18%, p<0.001, highly significant.). CONCLUSIONS: Simple Valsalva Maneuvers and verapamil proved to be effective in cardioversion of SVT/AVNRT. Both are safe. Verapamil is more successful in cardioversion as compared to Valsalva maneuvers.

Service Quality Dimensions And Patient Satisfaction: A Two-Sided Empirical Approach.

BACKGROUND: The present study attempts to investigate the impact of service quality dimensions (perceptions of patients as well as service providers) on patient satisfaction in public sector hospitals of Khyber Pakhtunkhwa province. The need to conduct research in this area is due to the growing importance of service quality in the healthcare sector. Thus, examining the two-sided role of service quality dimensions on patient satisfaction in the Province of KP is the main rationale behind the present study. METHODS: The data was conveniently collected from a sample of 600 patients and 200 service providers from six districts headquarter hospitals. The hypothesized relationships were tested via multiple regression analysis with the application of SPSS Version 23. RESULTS: Interestingly, divergent results were found from both perspectives. Six dimensions of service quality were found critical by the patients for their satisfaction whereas, only one dimension was found to be critical for patient satisfaction from service providers' perspective signifying that service providers are not meeting the expectations of the patients. CONCLUSIONS: The present study suggests the formulation of a sound patient-centred strategy in which patients are placed as value co-creators to increase their satisfaction with the services offered in public hospitals at KP Province, Pakistan. The study also discussed limitations, implications and future research directions.