Mitigating psychological distress in the workplace: The role of perceived insider status in leader-follower cognitive style congruence.

This study examines the impact of leader-follower cognitive style congruence on employee psychological distress, with a specific emphasis on the mediating role of perceived insider status. Using data from a major financial institution in China, the findings reveal that higher cognitive style alignment between leaders and followers is associated with a significant reduction in employee psychological distress. Grounded in Conservation of Resources (COR) theory, the study demonstrates that cognitive style congruence enhances predictability and facilitates the conservation of psychological resources, effectively mitigating psychological distress. Notably, employees led by intuitive leaders report lower distress levels compared to those led by analytic leaders. These results underscore the critical importance of cognitive style congruence in fostering employee well-being and offer actionable insights for enhancing organizational practices.

Linking Parent-Adolescent Congruence in Perceived Parental Emotional Support to Adolescent Developmental Outcomes: The More, the Better?

Parents and their children can have congruent or incongruent perceptions of parenting, which has been shown to have downstream effects on certain adolescent outcomes. However, little is known about whether such effect holds for various domains of developmental outcomes or across adolescent boys and girls. Investigating 2268 parent-girl (Mage = 15.73, SDage = 0.29, 75.5% were mothers) and 2090 parent-boy (Mage = 15.75, SDage = 0.29, 71.8% were mothers) dyads from Hong Kong, this study examined the associations between parent-adolescent (in)congruence and adolescent emotional symptoms, positive emotions, and academic performance. Polynomial regression and response surface analyses revealed that both congruence and incongruence were linked to emotional symptoms and positive emotions in varying patterns, but only congruence was tied to academic performance. Associations between (in)congruence and developmental outcomes generally were similar between boys and girls. These findings underscore the importance of decomposing (in)congruence effects in family processes and emphasizing the complexity of adolescent development.

The congruence between the preferred and actual places of death among terminal cancer patients in China.

Background: Dying in a preferred place is important for a good death. Currently, no study has evaluated the extent to which the preferences for the place of death (PoD) are met among terminal cancer patients in China. This study examined the congruence between the preferred and actual PoD and its predictors among terminal cancer patients in China. Methods: Between 2015 and 2023, 845 terminal cancer patients from four tertiary hospitals in Wuhan, China, were enrolled and followed till death. Face-to-face surveys at baseline and telephone-based interviews in the last month of patients' lives were combined to learn patients' preferred PoD. Data on patients' actual PoD were collected from families within 1 month after patients' death. Results: Of the 410 patients who died, 62.7% of them died in hospitals. The agreement between patients' preferred and actual PoD was fair (κ = 0.221). The congruence between patients' preferred and actual PoD was 63.0, 36.6%, and 0 for hospital death, home death, and hospice facility/nursing home death separately. Patients were more likely to die in their preferred places if their preferred place and family caregivers' belief of patients' preferred PoD was congruent (odds ratio [OR] = 6.464, p = 0.001), or if caregivers had a medically related occupation (OR = 4.577, p = 0.003); if patients were hospitalized at least twice in the last month of life (OR = 0.422, p = 0.000), or the quality of care received by patients in the last 48 h was rated good by the families (OR = 0.373, p = 0.011), patients were less likely to die in their preferred places. Conclusion: The congruence between patients' preferred and actual PoD was fair. Advance care planning (ACP) needs to be popularized in China, and the quality of care in hospice facilities and nursing homes should be improved. The necessary policy support for hospice care should be made to respect cancer patients' end-of-life (EoL) care preferences in China.

The Congruence and Interrelationship: A Dyadic Perspective on the Subjective Cognitive Impairment in the Patients with Colorectal Cancer and Their Spousal Caregivers.

OBJECTIVES: Patients with colorectal cancer (CRC) reported experiencing subjective cognitive impairment (SCI), and their spousal caregivers perceived the patients' SCI. This cross-sectional study assessed the congruence of SCI between the patients' self-reports and the spousal caregivers' perceptions and examined the factors affecting SCI from the dyadic perspective. METHODS: A total of 200 dyads of patients with CRC and their spousal caregivers were invited to complete the survey, which evaluated the SCI, dyadic coping (DC), quality of life, anxiety, and depression for the dyads. Congruence was analyzed using the intraclass correlation coefficient (ICC) and paired-sample t test. Impacting factors analysis was conducted using Pearson correlations, hierarchical multiple regression, and actor-partner interdependence mediation model. RESULTS: The congruency of SCI between the patient-reported and the spouse-perceived ranged from moderate to good (ICC = 0.75 to 0.86). After controlling demographic variables (the patients' gender and spouses' work status), the DC of both patients and spousal caregivers, and the emotional health of patients were significant predictors for patients' SCI (all P < .05). In the actor-partner interdependence mediation model, there was an actor effect between DC and SCI for both patients and spousal caregivers and a partner effect between DC and SCI for patients. Moreover, patients' emotional health (anxiety and depression) had the mediating effect between DC and SCI for both patients and spousal caregivers. CONCLUSION: Spousal caregivers played a vital role in assessment and management in the SCI of patients. The DC of patients and spousal caregivers and the emotional health of patients (eg, anxiety and depression) were major predictors for the SCI of patients. IMPLICATIONS FOR NURSING: Nursing providers should consider the importance of patients' and spousal caregivers' perspectives in assessing and managing SCI. This study supports nurses focusing on the congruence and interrelationship of SCI to enhance DC for CRC patients and their spousal caregivers. This approach aims to reduce emotional distress and develop cognitive interventions from a dyadic perspective.

The psychology of pandemic policy support: unraveling the complex interplay of personal values and value congruence across 20 European countries.

OBJECTIVES: We explored the roles of personal values and value congruence-the alignment between individual and national values-in predicting public support for pandemic restrictions across 20 European countries. STUDY DESIGN: Cross-sectional study. METHODS: We analyzed multinational European survey data (N = 34,356) using Schwartz's values theory and person-environment fit theory. Multilevel polynomial regression was employed to assess the linear and curvilinear effects of personal values on policy support. Multilevel Euclidean similarity analysis and response surface analysis were conducted to evaluate the impact of value congruence and delineate nuanced congruence patterns. RESULTS: Findings revealed that extreme levels of security, conformity, stimulation, hedonism, and achievement values were associated with decreased policy support. Value congruence with security, conformity, and benevolence increased support, while congruence with stimulation, hedonism, and achievement reduced it. High congruence between personal and national social focus values significantly boosted policy support. Extreme mismatches in self-direction values amplified support. Societal power exceeding personal power also increased support. Matched levels of hedonism motivated greater support, while stimulation and achievement value (in)congruence showed little impact. CONCLUSIONS: We highlight the differential effects of personal values and value congruence on public attitudes toward pandemic restrictions. The findings underscore the importance of considering the interplay between individual and societal values when designing and implementing effective pandemic response strategies.

Different Categories of Social Media Use and Their Association With Body Image Among Adolescents in 42 Countries.

Objectives: Social media has become integrated into adolescents' lives and influences body image perceptions. Our study examined four patterns of social media use (SMU): non-active, active, intensive, and problematic. We hypothesised that intensive SMU and problematic SMU would be associated with negative body image (negative subjective body weight) and over/underestimated body weight congruence, compared to non-active and active SMU. In addition, we expect these associations to be stronger for girls. Methods: Data from 190,892 respondents aged 11, 13, and 15 from 42 countries involved in the Health Behaviour in School-aged Children study were analysed. Results: Findings revealed higher rates of intensive or problematic SMU among adolescents who perceived themselves as too fat or too thin. Two-level regression analyses showed intensive and problematic SMU as more likely to perceive themselves as too fat or too thin than active users. The association was significant among intensive and problematic girl social media users, whereas, among boys, the relationship was only significant for problematic users. Conclusion: Our findings highlight the importance of assessing SMU patterns to evaluate associations with body image.

The Roles of Proactive Personality and Career Satisfaction in the Impact of Employer Brand Attributes Congruence on Creativity.

Although the relationship between employer brand and employee creativity has become a popular theme, this nexus is indirect and ambiguous. Additionally, most studies ignore the consistency of instrumental and symbolic attributes when discussing the consequences of employer brand. This study explored the mechanism of employer brand attributes congruence on employee creativity through career satisfaction, and further revealed the moderating role of proactive personality. Based on the cue consistency theory and the social information processing theory, a polynomial regression model was created and a response surface analysis was conducted using 488 paired questionnaires. The results showed that employer brand attributes congruence impacted employee creativity via career satisfaction. A consistent employer brand strategy is more effective for the creativity of less proactive individuals, while a high-level proactive personality can compensate for the deficiencies of employer brand attributes incongruence. The results complemented employer brand research from the perspective of the instrumental-symbolic attribute configuration and provided supportive empirical evidence of employer brand practices aiming at improving employee creativity. This study has certain practical implications for HR practitioners.

Congruence Between Older Chinese Immigrants and Their Adult Children on Hospice Attitudes and Preferences: An Actor-Partner Interdependence Model.

Objectives: This study investigates the alignment of awareness, attitudes, and preferences regarding hospice care between older Chinese immigrants and their adult children. Methods: Forty older Chinese immigrants and their adult children in New York City were assessed for their awareness, attitudes, and preferences for hospice care. McNemar's and Cohen's Kappa tests examined differences and congruence within parent-child dyads. The Actor-Partner Interdependence Model (APIM) was employed for dyadic analysis using structural equation modeling (SEM). Results: Discrepancies were observed between older parents and adult children, with the latter showing higher awareness and more positive attitudes toward hospice care compared to their parents. While 84.2% of older parents expressed willingness to accept hospice care, only 65.7% of their children believed their parents would desire hospice, and only 39.5% of children expressed a preference for hospice care for their parents. Kappa coefficients indicated poor-to-slight agreement within parent-child dyads, but there was a fair level of agreement in children's perceptions of their parents' preferences and their own preferences for parents. APIM revealed significant actor effects but nonsignificant partner effects, suggesting that parents' and children's preferences are influenced by their own attitudes, but not by those of other family members within the parent-child dyads. Conclusion: The incongruence in attitudes and preferences for hospice care between Chinese immigrant older adults and their children emphasizes the need for culturally-informed education and interventions to facilitate open conversations and ensure patient-centered end-of-life care for older Chinese immigrants.

Shyness and self-consistency and congruence among Chinese adolescents: mediating role of social comparison orientation and moderating role of self-focused attention.

During the critical period of personality shaping and self-development, adolescents face unique challenges and opportunities. This study, based on Cognitive-Behavioral Theory, explored the relationship between shyness and self-consistency and congruence (hereinafter referred to as SCC), as well as its underlying mechanisms. Through a questionnaire survey on shyness, social comparison orientation, self-focused attention, and SCC among 984 adolescents, the results revealed that (1) Adolescent shyness negatively predicted SCC. (2) Social comparison orientation partially mediated the relationship between shyness and SCC. (3) Self-focused attention moderated the direct pathway of this mediation process, where a high level of self-focused attention exacerbated the negative impact of shyness on SCC. These findings offered a new perspective on understanding SCC and underscored the importance of addressing the information processing mechanisms of social comparison orientation and self-focused attention among shy adolescents in interventions aimed at promoting their psychological harmony and healthy growth.

Three different patellar fixation techniques yield similar clinical and radiological outcomes in recurrent patellar dislocation undergoing medial patellofemoral ligament reconstruction.

PURPOSE: The purpose of this study was to evaluate and compare the clinical and radiological outcomes of three different patellar fixation techniques on medial patellofemoral ligament reconstruction (MPFLR) in the treatment of patellar dislocation (PD). METHODS: Between 2015 and 2020, 130 patients with recurrent PD who underwent surgical reconstruction were eligible for this retrospective study: 48 patients were treated with the semi-tunnel bone bridge fixation technique (Group A), 42 patients were treated with the suture anchor fixation technique (Group B) and 40 patients were treated with the transpatellar tunnel fixation technique (Group C). Clinical outcomes included functional outcomes (Kujala, Lysholm and International Knee Documentation Committee scores), activity levels (Tegner activity score and return to sports), physical examinations, patellar re-dislocation rate and complications. Radiological outcomes included patellar congruence angle, patellar tilt angle, lateral patellar translation and lateral patellar angle. RESULTS: All clinical and radiological outcomes improved significantly in all groups, without any significant difference among these three groups. At the final follow-up, no re-dislocation occurred, and all groups achieved a successful return to sports. However, the semi-tunnel bone bridge and suture anchor fixation techniques showed statistically higher Tegner activity scores (p = 0.004) and shorter time from surgery to return to sports (p = 0.007) than the transpatellar tunnel fixation technique. CONCLUSION: The three MPFLR patellar fixation techniques achieved favourable and comparable clinical and radiological outcomes in the treatment of PD. Compared with the transpatellar tunnel fixation technique, the semi-tunnel bone bridge and suture anchor fixation techniques may be more effective with higher activity levels. LEVEL OF EVIDENCE: Level III.

How Do Discrepancies between Subjective and Objective Health Predict the Risk of Injurious Falls? A Study of Community-Dwelling Swedish Older Adults.

OBJECTIVES: Previous studies demonstrated that discrepancies between subjective and objective health measures are associated with physical and mental health-related outcomes in older adults. We investigate whether such discrepancies are also associated with risk of injurious falls in community-dwelling Swedish older adults. DESIGN: A prospective, observational cohort study. SETTING AND PARTICIPANTS: Using data from the Swedish National Study on Aging and Care in Kungsholmen, we followed 2222 community-dwelling older adults aged ≥60 years at baseline, across a 10-year period of data collection (2001-2011). METHODS: A "health asymmetry" metric classified older adults into 4 categories, based on the level of agreement between their subjective and objective health scores ("health pessimist", "health optimist", "poor health realist", and "good health realist"). Time-varying Cox proportional hazard and Laplace regressions were employed to investigate if these categories were associated with the risk of injurious falls. RESULTS: Over a 10-year follow-up, 23.5% of the sample experienced an injurious fall. Health optimists had the greatest risk of experiencing an injurious fall [hazard ratio (HR) 2.16, 95% confidence interval (CI) 1.66, 2.80], compared with good health realists. Poor health realists (HR 1.77, 95% CI 1.50, 2.11) and health pessimists (HR 1.66, 95% CI 1.21, 2.29) also had an increased risk of experiencing injurious falls, compared with good health realists. Being a health pessimist was only associated with the risk of injurious falls within the younger-old (HR 2.43, 95% CI 1.63, 3.64) and among males (HR 1.95, 95% CI 1.14, 3.33). CONCLUSIONS AND IMPLICATIONS: Older adults with similar objective health levels may differ in terms of their injurious fall risk, depending on their subjective health. Interpreting subjective health alongside objective health is clinically pertinent when assessing injurious fall risk.

The Low Congruence between Plant and Animal Diversity in Field Ridges of Intensively Managed Paddy Landscapes, China.

Field ridges are commonly viewed as the stable semi-natural habitats for maintaining plant diversity in the agricultural landscape. The high plant diversity could further support higher animal diversity. But following the adoption of well-facilitated farmland construction measures in China, many field ridges have been disproportionately neglected or destroyed. Empirical studies delineating the relationships between plant and animal diversity in these field ridges in the paddy landscape remain scant, especially in China, which has the most rice production. A two-year field ridge evaluation was conducted in the Chengdu Plain area, covering 30 paddy landscapes. This investigation scrutinizes the shape attributes of field ridges, their plant diversity, and the associated animal α-diversity and community compositions, including spiders, carabids, birds, frogs, and rice planthoppers. In the results of Pearson's correlation analysis, a significant inconsistent correlation was observed between plant diversity and animal diversity. The analysis of community structure heterogeneity also revealed no correspondence for species composition between plant and animal communities (i.e., spiders, carabids, and birds), while the non-metric multidimensional scale analysis indicated a substantial difference in the species composition of spiders or plants even within the same field ridge between 2020 and 2021. We argue that the implementation of intensive management practices in paddy landscapes, such as machine ploughing and harvesting and herbicide spraying with drones, leads to a scarcity of stable animal and plant communities in field ridges. Therefore, besides retaining these field ridges in paddy landscapes, maintaining the long-term stable ridges by refraining from herbicide spraying or artificial weeding, as well as avoiding winter wheat cultivating in field ridges, will contribute to protecting biodiversity of field ridges as semi-natural habitats.

Anatomy and mobility in the adult cadaveric craniocervical junction.

Genetic diseases with craniofacial malformations can be associated with anomalies of the craniocervical joint (CCJ). The functions of the CCJ are thus impaired, as mobility may be either limited by abnormal bone fusion causing headaches, or exaggerated in the case of hypermobility, which may cause irreparable damage to the spinal cord. Restoring the balance between mobility and stability requires surgical correction in children. The anatomy and biomechanics of the CCJ are quite unique, yet have been overlooked in the past decades. Pediatric evidence is so scarce, that investigating the adult CCJ is our best shot to disentangle the form-function relationships of this anatomical region. The motivation of the present study was to understand the morphological and functional basis of motion in the CCJ, in the hope to find morphological features accessible from medical imaging able to predict mobility. To do so, we have quantified the in-vitro kinematics of the CCJ in nine cadaveric asymptomatic adults, and estimated a wide range of mobility variables covering the complexity of spinal motion. We compared these variables with the shape of the occipital, the atlas and the axis, obtained using a dense geometric morphometric approach. Morphological joint congruence was also quantified. Our results suggest a strong relationship between bone shape and motion, with the overall geometry predicting best the primary movements, and the joint facets predicting best the secondary movements. We propose a functional hypothesis stating that the musculoligamental system determines movements of great amplitude, while the shape and congruence of joint facets determine the secondary and coupled movements, especially by varying the geometry of bone stops and the way ligaments are tensioned. We believe this work will provide valuable insights in understanding the biomechanics of the CCJ. Furthermore, it should help surgeons treating CCJ anomalies by enabling them to translate objectives of functional and clinical outcome into clear objectives of morphological outcome.

The influence of leader-subordinate emotional intelligence congruence on the flow experience: evidence from the liquor manufacturing industry.

Previous research has provided evidence supporting a positive correlation between emotional intelligence (EI) and flow. However, intriguing findings in the liquor manufacturing industry prompt me to consider the necessity of examining the effects of leader-subordinate EI congruence on flow. Therefore, this article begins with two questions: First, what is the impact of leader-subordinate EI congruence on flow? Second, do two distinct congruent scenarios (i.e., high-high and low-low) exhibit significant nuances that differentially influence flow? To answer these questions, this study utilizes polynomial regression and three-dimensional response surface analysis methods. A multi-source and three-phase investigation method was used to collect data from 279 subordinates and 56 leaders in the liquor manufacturing industry. Based on the person-environment (PE) fit theory, this study investigates the influence of leader-subordinate EI congruence on flow while considering leader-member exchange (LMX) as a mediator in these processes. The current study not only demonstrates a positive relationship between leader-subordinate EI congruence and LMX, but also reveals that a high-high EI matching pattern can enhance the favorable dynamics of congruence and yield higher LMX compared to a low-low matching pattern. Furthermore, this study identifies LMX as a mediator in the positive relationship between leader-subordinate EI congruence and flow. Additionally, although the incongruent scenarios are beyond the scope of this study, the findings demonstrate that a high EI subordinate paired with a low EI leader has a more detrimental impact on the LMX than a low EI subordinate paired with a high EI leader. Theoretical and practical implications are discussed.

A critical review of the reporting of reflexive thematic analysis in Health Promotion International.

Using the concept of methodological congruence-where the different elements of a study 'fit' together-we explore both problematic and good practice in (reflexive) thematic analysis (TA) as reported in Health Promotion International (HPI). Aligning with the importance we place on 'owning your perspectives' we situate this exploration in relation to our understanding of the variation in approaches to TA and qualitative research more broadly. This contextualization is necessary for highlighting why we judge practices to be in/congruent, and to facilitate more knowing congruence in future research. We critically reviewed a 'sample' of 31 papers published in HPI between 2010 and 2023 citing Braun and Clarke as reference for TA. We overview a range of problematic and good features of the use of TA in HPI, before focusing on two domains that seemed to present key challenges: theory and themes. Methodological incongruence can occur when postpositivist values and practices unwittingly creep into ostensibly non-positivist TA; we encourage thoughtfully and what we term 'knowing' consideration of theory, and quality practices and criteria. Methodological incongruence can also occur through mismatched conceptualizations of themes-notably, the use of 'topic summaries' as themes for reflexive TA (and fragmented thematic structures with 'thin' themes). We provide examples from the reviewed papers to demonstrate good practice in researcher reflexivity, articulation of theoretical and methodological frameworks and congruent themes. However, mindful of power dynamics, we only discuss problematic practice in general terms, to protect author anonymity. To facilitate thoughtful, quality TA-of all kinds-we provide eight pointers for researchers (and reviewers) to guide quality practice, and facilitate the use of concepts, procedures and criteria that promote knowing methodological congruence.

Beyond person-environment congruence: Career adaptability, career personality styles, and thinking styles.

The main objectives of this study were to explore the relationship between career personality styles and career adaptability and the role of thinking styles in such relationship. Eight hundred and eleven Chinese students, who were trained as pre-service kindergarten teachers, responded to the Career Personality Styles Inventory, the shortened Thinking Styles Inventory-Revised, and the Career Adapt-Ability Scale - Short Form. Results suggested that the career personality styles (i.e. social, enterprising) that fit the vocational environment of kindergarten teaching the most positively predicted the students' career adaptability, both directly and indirectly through creativity-generating thinking styles. Moreover, the artistic and investigative career personality styles indirectly predicted students' career adaptability through creativity-generating thinking styles, while the conventional and realistic career personality styles showed no significant effect on the students' career adaptability. The findings imply that beyond the notion of person-environment congruence, some career personality styles can consistently predict career adaptability through thinking styles. Implications for career counseling and education practice are discussed.

Concordance among lacustrine communities are low and inconsistent in the conterminous United States.

Concordance occurs when two or more biological groups are correlated to each other. Examining the degree of concordance between communities has been a central goal in ecology. However, few studies have assessed the levels of community concordance at large spatial scales. We used a dataset obtained by the National Lakes Assessment (United States Environmental Protection Agency) to evaluate whether (i) the levels of concordance between aquatic communities were higher at the continental scale than within individual ecoregions of the United States and (ii) whether the levels of concordance between phytoplankton and zooplankton were higher than those between the plankton and macroinvertebrates communities. At the continental scale, the levels of concordance between different pairs of aquatic communities were low and did not exceed those within the ecoregions. Furthermore, levels of concordance varied considerably among ecoregions. Our results suggest that interactions between aquatic communities likely determined concordance patterns; however, the expectation of higher levels of concordance between the phytoplankton and zooplankton communities than between them and the macroinvertebrates community was not supported. The consistently low and variable levels of concordance suggest that using surrogate groups is not recommendable for monitoring lakes in the United States, both at the continental and regional scales. According to our results, the prospect of using the surrogacy approach was low even for aquatic communities that are highly interactive or driven by similar environmental factors.

Interplay of Adolescents' and Parents' Mindsets of Socioeconomic Status on Adolescents' Stress-Related Outcomes.

The reciprocity and variation of values and beliefs are dynamic features of the parent-child relationship. Parents and adolescents may hold congruent or incongruent views regarding the malleability of socioeconomic status (mindset of SES), potentially influencing adolescents' psychological and physiological stress outcomes, as reflected in stress perceptions and the hypothalamic-pituitary-adrenal (HPA) axis functioning. The current study investigated how patterns of parent-adolescent congruence and incongruence in mindset of SES were associated with adolescents' perceived stress and diurnal cortisol patterns four months later. A total of 253 adolescents (Mage = 12.60, 46.2% girls) and their parents (Mage = 40.09 years, 59.5% mothers) participated in this study. Polynomial regression analyses and response surface analyses showed that adolescents perceived lower levels of stress when they themselves or their parents reported a stronger growth mindset of SES. Additionally, adolescents with a stronger growth mindset of SES also exhibited a steeper diurnal cortisol slope. Moreover, parents' mindset significantly interacted with adolescents' mindset to influence adolescents' diurnal cortisol patterns such that when adolescents hold weaker growth mindset of SES, those with higher parental growth mindsets had significantly higher cortisol awakening response and steeper diurnal cortisol slope. Furthermore, adolescents who showed incongruence with their parents but had averagely stronger growth mindsets of SES reported a significantly steeper diurnal cortisol slope than those who had averagely weaker growth mindsets with their parents. The findings point to the beneficial impacts of the growth mindset of SES on stress-related outcomes among adolescents, as well as the significance of considering both parents' and adolescents' mindsets when exploring these associations.

Derotational distal femur osteotomy with medial patellofemoral ligament reconstruction can get good outcomes in the treatment of recurrent patellar dislocation with excessive TT-TG and increased femoral anteversion.

Background: Surgery is the main treatment for recurrent patellar dislocation (PD). However, due to the complexity of anatomical factors, there is still a lack of consensus on the choice of combined surgical methods. This study aimed to compare the clinical and radiological outcomes of medial patellofemoral ligament reconstruction combined with derotational distal femur osteotomies (MPFLR + DDFO) and combined with tibial tubercle osteotomies (MPFLR + TTO) for recurrent PD with increased femoral anteversion angles (FAA) and excessive tibial tubercle-trochlear groove (TT-TG) distance. Methods: In this retrospective analysis, MPFLR + DDFO and MPFLR + TTO patients from 2015 to 2020 were included. Group A (MPFLR + DDFO, n = 42) and B (MPFLR + TTO, n = 46) were formed. Clinical outcomes included physical examinations, functional outcomes (Kujala, Lysholm, International Knee Documentation Committee (IKDC), visual analog scale (VAS) and intermittent and persistent osteoarthritis pain scale (ICOAP), Tegner scores), and complications. The Caton-Deschamps index (CD-I), patellar title angle, patellar congruence angle, patella-trochlear groove distance, TT-TG distance, and FAA were used to assess radiological outcomes. Results: All clinical outcomes improved significantly in both groups, but Group A had significantly better postoperative scores than Group B (Kujala: 89.8 ± 6.4 vs. 82.9 ± 7.4, P < 0.01; Lysholm: 90.9 ± 5.1 vs. 81.3 ± 6.3, P = 0.02; IKDC: 87.3 ± 9.0 vs. 82.7 ± 8.0, P < 0.01; Tegner: 6.0 (5.0, 9.0) vs. 5.0 (4.0, 8.0), P = 0.01). However, there was no significant difference in the VAS and ICOAP scores between the two groups. No dislocation recurrences occurred. Radiological outcomes improved significantly in both groups, but Group A had better outcomes. After surgery, the patellar height of 88.5% (23/26) patients in Group A and 82.8% (24/29) patients in Group B was restored to normal (the Caton-Deschamps index <1.2). Conclusions: Both MPFLR + TTO and MPFLR + DDFO obtained satisfactory clinical and radiological outcomes in the treatment of recurrent PD with increased FAA and excessive TT-TG. However, the outcomes of MPFLR + DDFO were better and should be considered a priority. MPFLR + TTO may be not necessary for such patients.

Construed Organizational Ethical Climate and Whistleblowing Behavior: The Moderated Mediation Effect of Person-Organization Value Congruence and Ethical Leader Behavior.

An organizational ethical climate enhances the degree of collaboration and cohesion among employees and facilitates the development and interests of organizations. Such roles lead to organizational sustainable development and survival. Therefore, the importance of ethical climate in organizations is becoming increasingly apparent. In this background, this study aims to explore whether an organizational ethical climate can improve whistleblowing behavior and the mediating role of organizational identification in promoting whistleblowing behavior. Most previous studies have only focused on the mediating or moderating role of the model. This study expands the research field, adds the dual moderation of person-organization value congruence and leader ethical behavior, and verifies two moderated mediation models. Overall, the purpose of this study is to determine the behavior of employees under the influence of an organizational ethical climate and, on this basis, propose suggestions for strengthening organizational ethical climate, expanding the scope of research on organizational climate and providing a theoretical basis for related research. In order to achieve the research goals, the data were collected from 344 Chinese SMEs for empirical analysis. The results showed that an organizational ethical climate has no direct impact on whistleblowing behavior but could have a positive effect on whistleblowing formation through the mediating variable of organizational identification. In addition, person-organization value congruence and leader ethical behavior significantly moderated the mediating role of organizational identification between organizational ethical climate and whistleblowing behavior. Finally, the directions that can contribute to future research were suggested.