Leaders' emotional labour and abusive supervision: The moderating role of mindfulness.

In this study, we examine how leaders' emotional labour strategies (surface acting and deep acting) deplete leaders' self-control resources to predict abusive supervision, in addition to the moderating role of leader mindfulness. Integrating ego-depletion theory and emotion regulation theory, we hypothesise that deep acting and surface acting predict higher levels of abusive supervision, which is mediated by reduced self-control. Furthermore, we predict that leaders' trait mindfulness moderates the relationship between emotional labour and self-control on abusive supervision. Results from a three-wave study of leader-follower dyads supported mediation hypotheses; both deep and surface acting predicted abusive supervision, which is mediated by reduced self-control. Our moderated mediation hypotheses were supported for deep acting but not surface acting. This research contributes to the literature by demonstrating the depleting nature of emotional labour in leadership and the importance of leader mindfulness as a boundary condition that can make deep acting less harmful for leader behaviour.

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.

A Digital Intervention Using Daily Financial Incentives to Increase Medication Adherence in Severe Mental Illness: Single-Arm Longitudinal Pilot Study.

BACKGROUND: Medication nonadherence is prevalent in severe mental illness and is associated with multiple negative outcomes. Mobile technology and financial incentives show promise to improve medication adherence; however, studies in mental health, especially with oral medications, are lacking. OBJECTIVE: The aim of this paper is to assess the feasibility and effectiveness of offering financial incentives through a mobile app based on behavioral economics principles to improve medication adherence in severe mental illness. METHODS: A 10-week, single-arm longitudinal pilot study was conducted. Patients earned rewards in the context of app-based adherence incentives. The reward was split into biweekly payments made in increments of US $15, minus any US $2 per day penalties for missed check-ins. Time-varying effect modeling was used to summarize the patients' response during the study. RESULTS: A total of 25 patients were enrolled in this pilot study, of which 72% (n=18) were female, and 48% (n=12) were of a White racial background. Median age was 24 (Q1-Q3: 20.5-30) years. Participants were more frequently diagnosed with schizophrenia and related disorders (n=9, 36%), followed by major depressive disorder (n=8, 32%). App engagement and medication adherence in the first 2 weeks were higher than in the last 8 weeks of the study. At study endpoint, app engagement remained high (n=24, Z=-3.17; P<.001), but medication adherence was not different from baseline (n=24, Z=-0.59; P=.28). CONCLUSIONS: Financial incentives were effectively delivered using an app and led to high engagement throughout the study and a significantly increased medication adherence for 2 weeks. Leveraging behavioral economics and mobile health technology can increase medication adherence in the short term. TRIAL REGISTRATION: ClinicalTrials.gov NCT04191876; https://clinicaltrials.gov/ct2/show/NCT04191876.

Ecological Systems Affecting Urban Childbearing Puerto Rican Women in the City of Philadelphia.

OBJECTIVES: The purpose of this study was to explore socio-ecological influences affecting the daily lives of urban, pregnant Puerto Rican women and factors negatively influencing their health seeking behaviors related to prenatal care. METHODS: Qualitative, descriptive methods were used including individual interviews and focus groups to obtain maximum understanding of the women's lives. The interviews and focus groups were conducted using a semi-structured interview guide based on various components of the study's conceptual framework. Content analytic strategies included rigorous and systematic processes to increase trustworthiness: training, supervision, audits, electronic technologies, and ongoing input of the research team. RESULTS: Factors on all levels of the study's conceptual framework compound the effects of stressors and restrictions on the lives of urban, childbearing Puerto Rican woman. The intersectionality of issues for Puerto Rican women can either mitigate or heighten the pressure on their daily lives. CONCLUSIONS: This initial research sets the groundwork for further studies, such as narrative analysis, to better understand how to build appropriate and relevant interventions. Uncovering the women's stories gives them the opportunity to be a critical part of cross-sector partnerships towards the development of sustainable interventions.

Exploring Health Demographics of Female Collegiate Rowers.

CONTEXT: Limited information exists about health patterns among female rowers at the collegiate level. Furthermore, the element of weight class (lightweights classified as <130 lb [59 kg]) as a factor in the physical and mental health of female collegiate athletes has not been investigated, despite weight requirements in sport being a risk factor for the female athlete triad. OBJECTIVE: To test the hypotheses that (1) components of the female athlete triad were more prevalent in lightweight than in openweight rowers; (2) perceived stress levels were greater in lightweight than in openweight rowers; and (3) rowers who were unable to row due to injury had greater perceived stress levels than uninjured athletes. DESIGN: Cross-sectional study. SETTING: Twelve collegiate women's rowing programs consisting of 6 National Collegiate Athletic Association Division I openweight and 6 Intercollegiate Rowing Association-level lightweight teams. PATIENTS OR OTHER PARTICIPANTS: A total of 158 female collegiate rowers (78 lightweight, 80 openweight). MAIN OUTCOME MEASURE(S): An electronic survey addressing injury history, diet and eating habits and body image (according to the triad screening questionnaire), stress levels (Perceived Stress Scale), and athlete identity (Athlete Identity Measurement Scale) was administered. RESULTS: Lightweight rowers reported limiting or carefully controlling foods more frequently than openweight rowers (41.9% to 29.9%, P = .013). A history of an eating disorder was more prevalent among lightweight than openweight rowers (25.7% to 13.0%, P = .048). Prevalences of stress fractures and menstrual irregularities did not differ between weight classes. Lightweight and openweight rowers' scores on the Perceived Stress Scale (16.0 ± 9.9 and 17.3 ± 6.4, respectively) were not different. Injured rowers scored higher on the Perceived Stress Scale (19.4 ± 7.2) than did uninjured rowers (16.6 ± 5.72). CONCLUSIONS: Weight class did not contribute to differences in the prevalence of female athlete triad components or perceived stress, although lightweight rowers were more likely to have a history of eating disorder. Injury may be a risk factor for increased stress in this population.

The bright and dark sides of employee mindfulness: Leadership style and employee well-being.

In this study, we use a social information processing perspective to propose that employee mindfulness will boost the positive relationship between transformational leadership and employee well-being and will amplify the negative relationship between abusive supervision and employee well-being. We found, using a time-lagged survey of 246 employees (controlling for baseline well-being), that employee mindfulness strengthened the positive relationship between transformational leadership and psychological well-being. Furthermore, employee mindfulness intensified the relationship between abusive supervision and employee psychological well-being. This study shows the benefits of employee mindfulness in certain contexts and reveals one potential dark side of mindfulness at work. We conclude with a general discussion of this study and outline future directions for research.

Focused Ethnographic Examination of Barriers to Use of Long-Acting Injectable Antipsychotics.

OBJECTIVE: The authors designed this project to identify barriers to using long-acting formulations of antipsychotics. METHODS: The authors used a focused ethnographic approach. Patients, psychiatrists, nurses, therapists and administrators were interviewed about barriers to use of long-acting injectable (LAI) antipsychotics at six facilities in New York State, as were representatives from insurance firms, a pharmaceutical company, and a national professional organization. Interviews were conducted and analyzed by a central team not affiliated with the institutions. RESULTS: Interviews were obtained with 23 patients, 16 psychiatrists, three nurses, 23 therapists, 14 administrators, four insurers, one representative from a pharmaceutical industry, and one representative from a national organization. Major barriers identified from the interviews included restricting discussions about LAI medication to only patients with nonadherence or repeated hospitalizations; inadequate education efforts with patients about LAI antipsychotics; inadequate support for patients making medication decisions; lack of communication within the treatment team about issues relevant to use of LAI formulations by patients; therapists' limited knowledge about LAI antipsychotics, which restricted their role in supporting patients making treatment decisions; psychiatrist concerns about the pharmacologic properties of LAI formulations; lack of clinic infrastructure to support LAI prescriptions; and payer concerns about whether the immediate costs of LAI administration would translate into later potential cost benefits. CONCLUSIONS: Effective shared decision making about use of LAI antipsychotics requires that patients receive accurate information and support for their decision making. The training needs and administrative support requirements of all team members should be considered to provide patients with the information and support required.

Impact of community respiratory viral infections in urban children with asthma.

BACKGROUND: Upper respiratory tract viral infections cause asthma exacerbations in children. However, the impact of natural colds on children with asthma in the community, particularly in the high-risk urban environment, is less well defined. OBJECTIVE: We hypothesized that children with high-symptom upper respiratory viral infections have reduced airway function and greater respiratory tract inflammation than children with virus-positive low-symptom illnesses or virus-negative upper respiratory tract symptoms. METHODS: We studied 53 children with asthma from Detroit, Michigan, during scheduled surveillance periods and self-reported respiratory illnesses for 1 year. Symptom score, spirometry, fraction of exhaled nitric oxide (FeNO), and nasal aspirate biomarkers, and viral nucleic acid and rhinovirus (RV) copy number were assessed. RESULTS: Of 658 aspirates collected, 22.9% of surveillance samples and 33.7% of respiratory illnesses were virus-positive. Compared with the virus-negative asymptomatic condition, children with severe colds (symptom score ≥5) showed reduced forced expiratory flow at 25% to 75% of the pulmonary volume (FEF25%-75%), higher nasal messenger RNA expression of C-X-C motif chemokine ligand (CXCL)-10 and melanoma differentiation-associated protein 5, and higher protein abundance of CXCL8, CXCL10 and C-C motif chemokine ligands (CCL)-2, CCL4, CCL20, and CCL24. Children with mild (symptom score, 1-4) and asymptomatic infections showed normal airway function and fewer biomarker elevations. Virus-negative cold-like illnesses demonstrated increased FeNO, minimal biomarker elevation, and normal airflow. The RV copy number was associated with nasal chemokine levels but not symptom score. CONCLUSION: Urban children with asthma with high-symptom respiratory viral infections have reduced FEF25%-75% and more elevations of nasal biomarkers than children with mild or symptomatic infections, or virus-negative illnesses.

Mindfulness as a Buffer of Leaders' Self-Rated Behavioral Responses to Emotional Exhaustion: A Dual Process Model of Self-Regulation.

In this study, we investigate the self-regulatory role of mindfulness in buffering the relationship between leaders' emotional exhaustion and self-rated leadership behavior (transformational leadership and abusive supervision). Specifically, we propose that leader mindfulness buffers the relationship between emotional exhaustion and both negative affect and impaired perspective taking, which link leader emotional exhaustion and leadership behavior (i.e., moderated mediation). Using a time-lagged survey of leaders (N = 505) we found that leader perspective taking and negative affect mediated the relationships between emotional exhaustion and self-reported leadership behavior. Furthermore, we found that leader mindfulness buffers the relationship between emotional exhaustion and negative affect, which weakened the mediated relationship between emotional exhaustion and both transformational leadership and abusive supervision. However, leader mindfulness did not moderate the relationship between emotional exhaustion and perspective taking. Theoretical and practical implications are discussed.

Rhinovirus infection induces distinct transcriptome profiles in polarized human macrophages.

Infections with rhinovirus (RV) cause asthma exacerbations. Recent studies suggest that macrophages play a role in asthmatic airway inflammation and the innate immune response to RV infection. Macrophages exhibit phenotypes based on surface markers and gene expression. We hypothesized that macrophage polarization state alters gene expression in response to RV infection. Cells were derived from human peripheral blood derived monocytes. M1 and M2 polarization was carried out by using IFN-γ and IL-4, respectively, and RNA was extracted for Affymetrix Human Gene ST2.1 exon arrays. Selected genes were validated by quantitative (q)PCR. Treatment of nonactivated (M0) macrophages with IFN-γ and IL-4 induced the expression of 252 and 153 distinct genes, respectively, including previously-identified M1 and M2 markers. RV infection of M0 macrophages induced upregulation of 232 genes; pathway analysis showed significant overrepresentation of genes involved in IFN-α/ß signaling and cytokine signaling in the immune system. RV infection induced differential expression of 195 distinct genes in M1-like macrophages but only seven distinct genes in M2-like-polarized cells. In a secondary analysis, comparison between M0-, RV-infected, and M1-like-polarized, RV-infected macrophages revealed differential expression of 227 genes including those associated with asthma and its exacerbation. qPCR demonstrated increased expression of CCL8, CXCL10, TNFSF10, TNFSF18, IL6, NOD2, and GSDMD and reduced expression of VNN1, AGO1, and AGO2. Together, these data show that, in contrast to M2-like-polarized macrophages, gene expression of M1-like macrophages is highly regulated by RV.

The fracture toughness of eggshell.

UNLABELLED: The shells of avian eggs are very brittle, but how brittle? Fracture toughness, Kc is a standard measure used widely to characterise engineering materials. We devised a novel way to measure Kc and applied it to commercial hens' eggs, obtaining a value of 0.3MPa√m. This value is much lower than previous published values, which we argue are incorrect and misleading. We discuss how this exceptionally low toughness value (in comparison to that of other natural materials made from calcium carbonate) has been achieved by prevention of toughening mechanisms. Eggshell has an unusual combination of mechanical properties (low fracture toughness combined with high Young's modulus), making it ideally suited as a container for the developing chick, which must be stiff and rigid but also brittle enough to be broken when required. Further testing and analysis using the Theory of Critical Distances and Weibull probability theory allowed us to describe the effects of defects of various types: cracks, holes and notches, on the strength of whole eggs. These results are of commercial importance because many eggs break prematurely as a result of microscopic defects. STATEMENT OF SIGNIFICANCE: This paper presents the first accurate measurements of the fracture toughness of eggshell. These results are important because eggshell is a brittle material which fails from microscopic defects, so knowledge of the fracture toughness is essential to understand its mechanical performance. The toughness value obtained is discussed in the context of other mechanical properties, of eggshell and other natural materials. This is useful for understanding how eggshell's stiffness and toughness make it ideally suited to its purpose, and the mechanisms by which toughness is achieved. The paper also contains analysis of the effect of defect type, including cracks, notches and holes, to provide a fuller picture of defect tolerance which will be useful in the egg producing industry.

Patient Handoffs in Nephrology Nurse Practice Settings: A Safety Study.

Research investigating patient handoff processes has inundated the safety literature, but not in nephrology nurse practice settings. Effective patient handoffs are essential for maintaining patient safety by avoiding errors related to poor information exchange. This mixed methods research study investigated the process of patient handoff across nephrology practice settings and the implications for patient safety and nursing practice. Findings indicate there are too frequently issues with handoffs of patients with chronic kidney disease who must move between many different healthcare providers and healthcare settings. Nephrology nurses reported thar the use of multiple methods for handoff communications and practice sites having differing hours of operation present challenges to practitioners, which result in information too often "falling through the cracks."

Proton pump inhibitors for the treatment of cancer in companion animals.

The treatment of cancer presents a clinical challenge both in human and veterinary medicine. Chemotherapy protocols require the use of toxic drugs that are not always specific, do not selectively target cancerous cells thus resulting in many side effects. A recent therapeutic approach takes advantage of the altered acidity of the tumour microenvironment by using proton pump inhibitors (PPIs) to block the hydrogen transport out of the cell. The alteration of the extracellular pH kills tumour cells, reverses drug resistance, and reduces cancer metastasis. Human clinical trials have prompted to consider this as a viable and safe option for the treatment of cancer in companion animals. Preliminary animal studies suggest that the same positive outcome could be achievable. The purpose of this review is to support investigations into the use of PPIs for cancer treatment cancer in companion animals by considering the evidence available in both human and veterinary medicine.

Resistance to cancer chemotherapy: failure in drug response from ADME to P-gp.

Cancer chemotherapy resistance (MDR) is the innate and/or acquired ability of cancer cells to evade the effects of chemotherapeutics and is one of the most pressing major dilemmas in cancer therapy. Chemotherapy resistance can arise due to several host or tumor-related factors. However, most current research is focused on tumor-specific factors and specifically genes that handle expression of pumps that efflux accumulated drugs inside malignantly transformed types of cells. In this work, we suggest a wider and alternative perspective that sets the stage for a future platform in modifying drug resistance with respect to the treatment of cancer.

Leadership styles, emotion regulation, and burnout.

This study investigated the potential impact of leadership style on leaders' emotional regulation strategies and burnout. Drawing on the full-range model of leadership and Conservation of Resources (COR) theory, we tested whether transformational, contingent reward, management by exception-active and -passive, or laissez-faire leadership exert direct effects on leaders' reported use of surface acting, deep acting, and genuine emotion. In turn, we hypothesized and tested the indirect effect of leadership on burnout through surface acting. Three waves of data from 205 leaders were analyzed using OLS regression. Transformational leadership predicted deep acting and genuine emotion. Contingent reward predicted both surface and deep acting. Management by exception-active and -passive predicted surface acting, and laissez faire predicted genuine emotion. The indirect effects of management by exception-active and -passive on burnout through surface acting were not significant. Indirect effects of transformational leadership and laissez-faire on burnout through genuine emotion, however, were significant. This study provides empirical evidence for the hypothesized relationships between leadership style, emotion regulation, and burnout, and provides the basis for future research and theory building on this topic.

Guide to performing cardiac surgery in patients with hereditary bleeding disorders.

BACKGROUND AND AIM: This study presents the experience of a large Australian hospital in performing cardiac surgery on patients with hereditary bleeding disorders (HBDs) and provides a suggested approach for their perioperative management. METHODS: Medical records of patients with HBDs who underwent cardiac surgery from January 1997 to December 2013 were reviewed. RESULTS: Seventeen patients were included in this study, 13 with Hemophilia A, one symptomatic Hemophilia A carrier, one with Hemophilia B, and two with von Willebrand Disease. Cardiac surgical procedures performed included 10 coronary artery bypass graft (CABG) operations, two aortic valve replacements, two mitral valve repairs, two aortic root replacements, and one combined aortic valve replacement and CABG. Perioperative management centered on factor substitution to maintain normal factor levels. Perioperative outcomes including length of hospital stay, mortality, and return to the operating room for bleeding were recorded. Two patients returned to the operating room for bleeding, one patient on the first postoperative day and one patient at day 20 postoperatively with pericardial bleeding. CONCLUSIONS: Most patients demonstrated excellent hemostasis, suggesting that cardiopulmonary bypass surgery in HBD patients may be safely performed with careful planning.

Long-term perspective on wildfires in the western USA.

Understanding the causes and consequences of wildfires in forests of the western United States requires integrated information about fire, climate changes, and human activity on multiple temporal scales. We use sedimentary charcoal accumulation rates to construct long-term variations in fire during the past 3,000 y in the American West and compare this record to independent fire-history data from historical records and fire scars. There has been a slight decline in burning over the past 3,000 y, with the lowest levels attained during the 20th century and during the Little Ice Age (LIA, ca. 1400-1700 CE [Common Era]). Prominent peaks in forest fires occurred during the Medieval Climate Anomaly (ca. 950-1250 CE) and during the 1800s. Analysis of climate reconstructions beginning from 500 CE and population data show that temperature and drought predict changes in biomass burning up to the late 1800s CE. Since the late 1800s , human activities and the ecological effects of recent high fire activity caused a large, abrupt decline in burning similar to the LIA fire decline. Consequently, there is now a forest "fire deficit" in the western United States attributable to the combined effects of human activities, ecological, and climate changes. Large fires in the late 20th and 21st century fires have begun to address the fire deficit, but it is continuing to grow.

Binding serial order to representations in working memory: a spatial/verbal dissociation.

Verbal information is coded naturally as ordered representations in working memory (WM). However, this may not be true for spatial information. Accordingly, we used memory span tasks to test the hypothesis that serial order is more readily bound to verbal than to spatial representations. Removing serial-order requirements improved performance more for spatial locations than for digits. Furthermore, serial order was freely reproduced twice as frequently for digits as for locations. When participants reordered spatial sequences, they minimized the mean distance between items. Participants also failed to detect changes in serial order more frequently for spatial than for verbal sequences. These results provide converging evidence for a dissociation in the binding of serial order to spatial versus verbal representations. There may be separable domain-specific control processes responsible for this binding. Alternatively, there may be fundamental differences in how effectively temporal information can be bound to different types of stimulus features in WM.