Good, Bad, and Ugly Leadership Patterns: Implications for Followers' Work-Related and Context-Free Outcomes.

This research responds to calls for a more integrative approach to leadership theory by identifying subpopulations of followers who share a common set of perceptions with respect to their leader's behaviors. Six commonly researched styles were investigated: abusive supervision, transformational leadership (TFL), contingent reward (CR), passive and active management-by-exception (MBE-P and MBE-A, respectively), and laissez faire/avoidant (LF/A). Study hypotheses were tested with data from four independent samples of working adults, three from followers (N = 855) and a validation sample of leaders (N = 505). Using latent profile analysis, three pattern cohorts emerged across all four samples. One subpopulation of followers exhibited a constructive pattern with higher scores on TFL and CR relative to other styles. Two cohorts exhibited destructive patterns, one where the passive styles of MBE-A, MBE-P and LF/A were high relative to the other styles (passive) and one where the passive styles co-occurred with abusive supervision (passive-abusive). Drawing on conservation of resources theory, we confirmed differential associations with work-related (i.e., burnout, vigor, perceived organizational support and affective organizational commitment) and context-free (i.e., physical health and psychological well-being) outcomes. The passive-abusive pattern was devastating for physical health, yet passiveness without abuse was damaging for psychological well-being. Interestingly, we find a clear demarcation between passiveness as "benign neglect" and passiveness as an intentional and deliberate form of leadership aimed at disrupting or undermining followers-hence, the two faces of passiveness: "bad" and "ugly." We discuss the novel insights offered by a pattern (person)-oriented analytical strategy and the broader theoretical and practical implications for leadership research.

Anonymous HIV testing: what does it mean in policy and practice? A case study in Newfoundland and Labrador, Canada.

HIV infection is not a legally notifiable disease at the national level in Canada; however, provincial and territorial officials voluntarily undertake notification to the Public Health Agency of Canada. A case study involving four community-based sites in Newfoundland and Labrador found that the absence of clear legislation concerning HIV testing presented challenges for nurses who had to interpret and comply with provincial legislation and agency policy while meeting the needs of test-seekers. This ambiguous messaging is part of other conflicting information about the availability of anonymous HIV testing that, along with other factors, may contribute to under-testing and under-diagnosis in the province. From a social justice perspective, developing a national HIV strategy and amending legislation to facilitate anonymous HIV testing might provide clearer direction to nurses and agencies, and promote public health by improving service delivery and increasing testing in under-tested, higher-risk-taking populations.

Hull early walking aid for rehabilitation of transtibial amputees--randomized controlled trial (HEART).

PURPOSE: To compare articulated and nonarticulated early walking aids (EWAs) for clinical and quality-of-life outcomes in transtibial amputees. METHODS: Patients undergoing lower limb amputation in a tertiary-care vascular surgical unit were screened over a 4-year period. Recruited patients were randomized to receive articulated amputee mobility aid (AMA) or nonarticulated pneumatic postamputation mobility aid (PPAMA) during early rehabilitation. Primary (10-meter walking velocity) and secondary clinical (number and duration of physiotherapy treatments during EWA/prosthesis use) and quality-of-life (SF-36) outcome measures were recorded at five standardized assessment visits. Inter-group and intra-group analyses were performed. RESULTS: Two hundred seventy-two patients were screened and 29 transtibial amputees (median age, 56 years) were recruited (14/treatment arm). No significant difference was seen in demographics and comorbidities at baseline. Inter-group analysis: Median 10-meter walking velocity was significantly (Mann-Whitney, P = .020) faster in the PPAMA group (0.245 m/s, interquartile range [IQR] 0.218-0.402 m/s) compared with the AMA group (0.165 m/s; IQR, 0.118-0.265 m/s) at visit 1. However, there was no difference between the groups at any other visit. Similarly, the number of treatments using EWA was significantly (P = .045) lower in the PPAMA group (5.0; IQR, 3.5-8.0) compared with the AMA group (6.0; IQR, 6.0-10.5). No difference was observed between the groups in duration of physiotherapy or SF-36 domain and summary scores. Intra-group analysis: Both treatment groups showed significant improvement in 10-meter walking velocity (Friedman test; AMA P = .001; PPAMA P = .007); however, other clinical outcomes did not show any statistically significant improvement. Only physical function domain of SF-36 demonstrated significant improvement (Friedman test; AMA P = .037; PPAMA P = .029). CONCLUSIONS: There is no difference in clinical and QOL outcomes between articulated and nonarticulated EWAs in rehabilitation of transtibial amputees.

Kinematic gait adaptations in unilateral transtibial amputees during rehabilitation.

INTRODUCTION: Physiotherapists routinely prescribe the use of two different early walking aids (EWAs) to individuals who have recently undergone unilateral transtibial amputation. No research to date has investigated the kinematic gait patterns of transtibial amputees walking with an EWA during early rehabilitation. The aim of the current RCT study was to compare gait patterns when walking with two different EWAs and whether either EWA provided patients with greater gait benefits. METHODS: Patients were randomly assigned into one of two EWA groups, one group using the Amputee Mobility Aid and another using the Pneumatic Post-Amputation Aid, prior to receiving their functional prosthesis. A 3D motion capture system recorded kinematic data from their first steps up to discharge from rehabilitation. RESULTS: Walking velocity increased significantly (p < 0.01) during rehabilitation. Control of the prosthetic knee improved during rehabilitation in both groups. A lack of conclusive differences between EWAs was noted at discharge from rehabilitation. DISCUSSION: Both groups displayed changes in gait patterns in different gait measures during rehabilitation. However, these changes were not the same for both groups. Gait adaptations occurred soon after walking with a functional prosthesis. CONCLUSION: The results from this study would suggest that neither EWA was more beneficial for gait retraining during rehabilitation.