[Check valves : Important facts for safe use]

Patients benefit from the use of check valves when drugs with a particularly short half-life (e.g., catecholamines) are continually administered through a one-way valve or when an accidental retrograde bolus application must be prevented, as in the event of a rapid sequence induction and intubation. The lack of a check valve can prevent the administered drug from working in the intended manner resulting in potentially insufficient treatment and negative consequences for the patient. In order to ensure the highest level of patient safety while using check valves appropriate training of medical personnel is essential. In contrast, preventable dangers (e.g., infections, awareness) exist when safety measures are disregarded, including the re-use of medications, syringes or disposable materials in successive patients after having only exchanged the check valves. It is not clear how often this is practiced in German-speaking areas.

External Validation of Models for Predicting Disability in Community-Dwelling Older People in the Netherlands: A Comparative Study

Background

Advanced statistical modeling techniques may help predict health outcomes. However, it is not the case that these modeling techniques always outperform traditional techniques such as regression techniques. In this study, external validation was carried out for five modeling strategies for the prediction of the disability of community-dwelling older people in the Netherlands.

Methods

We analyzed data from five studies consisting of community-dwelling older people in the Netherlands. For the prediction of the total disability score as measured with the Groningen Activity Restriction Scale (GARS), we used fourteen predictors as measured with the Tilburg Frailty Indicator (TFI). Both the TFI and the GARS are self-report questionnaires. For the modeling, five statistical modeling techniques were evaluated: general linear model (GLM), support vector machine (SVM), neural net (NN), recursive partitioning (RP), and random forest (RF). Each model was developed on one of the five data sets and then applied to each of the four remaining data sets. We assessed the performance of the models with calibration characteristics, the correlation coefficient, and the root of the mean squared error.

Results

The models GLM, SVM, RP, and RF showed satisfactory performance characteristics when validated on the validation data sets. All models showed poor performance characteristics for the deviating data set both for development and validation due to the deviating baseline characteristics compared to those of the other data sets.

Conclusion

The performance of four models (GLM, SVM, RP, RF) on the development data sets was satisfactory. This was also the case for the validation data sets, except when these models were developed on the deviating data set. The NN models showed a much worse performance on the validation data sets than on the development data sets.

Systematic review of common and specific factors in play therapy for young people with intellectual disability

Background: The target group of this study concerns young people with a mild intellectual disability. The central research question is: What evidence can be found in the literature for common and specific factors for a play therapy intervention for young people with a mild intellectual disability struggling with aggression regulation. Method: The criteria used for selecting articles are presented according to the PRISMA, and the PRISMA guidelines for writing a review have been applied. Results: Common factors have been found in the literature that relate to the relationship between therapist and client and the therapeutic skills of the play therapist. Clues have also been found for specific factors of play therapy, such as the use of play as a language and a connection with the child's inner world. In addition, certain factors have been found that are specific to the target group of this article. The non-verbal element of play therapy is an active part of this.

Vulnerable persons in society: an insider's perspective

Purpose: Self-reliance and social participation are strongly promoted by social policy. Both concepts are linked to the concept of vulnerability, for people who do not meet these standards are labelled "vulnerable people". In this paper, the insider's perspective takes central stage by seeking to explore what it means to be labelled a "vulnerable person", and through this to further our insight into the meaning of the concept of vulnerability. Method: Thirty-three in-depth interviews were conducted with 16 allegedly vulnerable people. The data were subjected to thematic content analysis. Results: Our analysis revealed three main dimensions and eight sub-dimensions of perceived vulnerability, outlining an insider's concept of vulnerability. This concept includes manifestations of vulnerability, feelings coexisting with vulnerability, and the image of vulnerable people. Conclusion: The perception of vulnerability changes when interacting with others in society, especially with social policy implementers. In this interaction, the perceived vulnerability increases and becomes societal vulnerability. It concerns a dependency situation in which one's strength and self-determination are not recognized, and the help needed is not provided. By acknowledging the insider's perspective, social policy can fulfil a more empowering role towards "vulnerable people" and contribute to people's well-being.

Perceptions of HPWS and performance: cross-level effects of team psychological contracts

Purpose

This present study aims to examine how experiences of high-performance work systems (HPWS) in work teams affect employee’s work attitudes and performance. At the team level, the study explored the role of supervisory support in the relationship experienced HPWS -team performance. In explaining employee attitudes and behaviours at the individual level, such as organisational citizenship behaviour (OCB), the study adopted a psychological contract approach.

Design/methodology/approach

The moderating role of supervisory support was investigated at the team level while exploring mediation effects of psychological contract beliefs in work teams in cross-level relationships with individual attitudes and behaviours.

Findings

Results indicate partial mediation of fulfilment of psychological contracts in work teams in the experienced HPWS-OCB relationship. At the team level, supervisory support perceptions moderate the effects of shared experiences of HPWS on product and service innovation in work teams.

Originality/value

The focus on the employee perspective of HPWS, the factor-analytic approach of measuring HPWS experiences and the role of team psychological contracts in employee attitudes and behaviours represent the main contributions of this study to HR research.

A systematic review on organizational empowerment

Purpose

This paper aims to present a systematic review on organizational empowerment (OE) using Peterson and Zimmerman´s model (2004) as a starting point. The aim is to further conceptualize OE, discover how the components in the model influence each other and identify recommendations for future research.

Design/methodology/approach

All articles that cited the OE model, published in 2004 by Peterson and Zimmerman, have been systematically reviewed. In total, 37 studies of 410, found in Google Scholar and Web of Science, are included in the review.

Findings

The review revealed that intra-, inter- and extra-organizational empowerment affect each other and that evidence for the processes and outcomes on intra-organizational empowerment have increased, but there is limited additional evidence for the other two components.

Research limitations/implications

Literature was searched in two databases, focusing on the OE model. A search using other databases on OE as a broad concept might provide additional sources.

Practical implications

Findings are relevant for professionals, leaders in human service organizations, educators and researchers. Practice can be improved by applying the knowledge; educators can use the results in their program and researchers may use the findings for the further development of OE.

Originality/value

Since the OE model was presented in 2004, no systematic review has been performed. Therefore, this review contributes to the further conceptualization of OE.

"You Can See How Things Will End by the Way They Begin": The Contribution of Early Mutual Obligations for the Development of the Psychological Contract

This study explores dynamic processes in the development of the psychological contract, focusing on the interaction of obligations related to the two parties (i.e., employees' perceptions of both their own and the organization's obligations fulfillment) on attitudinal outcomes (organizational commitment and turnover intention) during the initial stage of the employment relationship. In a twofold cross-sectional and two-wave study on newly hired correctional police officers, we examined: (a) whether perception of organizational obligations fulfillment moderates the relationship between employee obligations and their attitudes (Study 1, n.500); (b) the direct and moderated influence of perceived obligations at the entrance stage on those in the following months (Study 2, n.223). Results confirmed that, in the eyes of the newcomer, the obligations fulfillment of each of the two parties interact, having an additional effect beyond the main direct effects, in influencing both subsequent obligations perceptions and, through this, the outcome variables. Theoretical and practical implications of the findings are discussed.

Actively Coping with Violation: Exploring Upward Dissent Patterns in Functional, Dysfunctional, and Deserted Psychological Contract End States

Recently, scholars have emphasized the importance of examining how employees cope with psychological contract violation and how the coping process contributes to psychological contract violation resolution and post-violation psychological contracts. Recent work points to the important role of problem-focused coping. Yet, to date, problem-focused coping strategies have not been conceptualized on a continuum from constructive to destructive strategies. Consequently, potential differences in the use of specific types of problem-focused coping strategies and the role these different strategies play in the violation resolution process has not been explored. In this study, we stress the importance of focusing on different types of problem-focused coping strategies. We explore how employee upward dissent strategies, conceptualized as different forms of problem-focused coping, contribute to violation resolution and post-violation psychological contracts. Two sources of data were used. In-depth interviews with supervisors of a Dutch car lease company provided 23 case descriptions of employee-supervisor interactions after a psychological contract violation. Moreover, a database with descriptions of Dutch court sentences provided eight case descriptions of employee-organization interactions following a perceived violation. Based on these data sources, we explored the pattern of upward dissent strategies employees used over time following a perceived violation. We distinguished between functional (thriving and reactivation), dysfunctional (impairment and dissolution) and deserted psychological contract end states and explored whether different dissent patterns over time differentially contributed to the dissent outcome (i.e., psychological contract end state). The results of our study showed that the use of problem-focused coping is not as straightforward as suggested by the post-violation model. While the post-violation model suggests that problem-focused coping will most likely contribute positively to violation resolution, we found that this also depends on the type of problem-focused coping strategy used. That is, more threatening forms of problem-focused coping (i.e., threatening resignation as a way to trigger one's manager/organization to resolve the violation) mainly contributed to dysfunctional and deserted PC end states. Yet, in some instances the use of these types of active coping strategies also contributed to functional violation resolution. These findings have important implications for the literature on upward dissent strategies and psychological contract violation repair.

Flexibele arbeidsrelaties: de gevolgen voor organisaties en werkenden

Dit artikel introduceert het themanummer over flexibele arbeidsrelaties. Het grootste deel van onze wetenschappelijke kennis over gedrag in organisaties is gebaseerd op mensen met een vast arbeidscontract. Er zijn echter redenen om aan te nemen dat mensen met een flexibele arbeidsrelatie ander gedrag, andere attitudes en andere gevolgen van HRM en leiderschap ervaren als gevolg van de flexibele aard van hun contract. Ondanks het feit dat flexibilisering al jaren speelt, staat onderzoek naar de flexibele arbeidsrelatie in de kinderschoenen. Zo is er gebrek aan een duidelijke conceptualisatie van wat flexibele arbeid precies inhoudt, is er geen toepasbare theorie en zijn er geen geschikte meetinstrumenten, en ontbreekt het aan eenduidige en generaliseerbare onderzoeksconclusies. Dit themanummer belicht met een omvangrijke literatuurstudie, twee kwantitatieve studies en een kwalitatieve studie flexwerk in de publieke sector, combibanen en loopbaanpatronen van zzp'ers.

Kwaliteitsstandaarden voor de ontwikkeling van instrumenten voor het evalueren van empowerment

Dit artikel gaat in op de vraag aan welke theoretische vereisten moet worden voldaan bij de ontwikkeling van instrumenten voor het evalueren van empowerment. Een gerichte literatuurstudie en een kritische reflectie op bestaande meet- en evaluatie-instrumenten resulteerden in het formuleren van vijf kwaliteitsstandaarden. In de empirische fase ging het in de eerste plaats om het nagaan of de toepassing van deze theoretische kwaliteitsstandaarden in de praktijk van instrumentontwikkeling haalbaar is: leiden ze tot een instrument en is dit instrument toepasbaar? De concrete focus van deze empirische toets lag op empowerment op het niveau van een organisatie, hetgeen betekent dat instrumenten werden ontwikkeld om in kaart te brengen hoe 'empowering' organisaties zijn voor hun medewerkers én hoe 'empowered' ze zijn in hun sociale omgeving. Deze instrumentontwikkelingstrajecten vonden plaats in een openbare en in een private eerstelijns welzijnsorganisatie in Vlaanderen. Het resultaat onderschrijft de haalbaarheid van de geformuleerde kwaliteitsstandaarden voor instrumentontwikkeling. De concrete uitwerking geeft meteen een overzicht van datgene waarover het gaat wanneer een organisatie zichzelf als een 'empowering' en 'empowered' organisatie wil evalueren en versterken.

Psychological Contract Breach in the Anticipatory Stage of Change

This study examined the impact of two types of psychological contract breach (organizational policies and social atmosphere breach) on resistance to change and engagement in the anticipatory phase of change and assessed whether supervisory informational justice mitigated the negative effects of breach. Employees from three departments of a Dutch financial institution ( n = 141) who were in the first phase of a change initiative participated in the study. Results showed that social atmosphere breach was positively related to affective resistance to change and negatively related to engagement, while organizational policies breach was positively related to cognitive resistance to change. These findings point to the importance of distinguishing between different types of psychological contract breach. In addition, it was found that supervisory informational justice mitigated the adverse effect of social atmosphere breach on cognitive resistance to change, pointing to the important role of managers in the first phase of change.

Social Workers' Orientation Toward the Evidence-Based Practice Process: A Dutch Survey

OBJECTIVES

This study assesses social workers' orientation toward the evidence-based practice (EBP) process and explores which specific variables (e.g. age) are associated.

METHODS

Data were collected from 341 Dutch social workers through an online survey which included a Dutch translation of the EBP Process Assessment Scale (EBPPAS), along with 13 background/demographic questions.

RESULTS

The overall level of orientation toward the EBP process is relatively low. Although respondents are slightly familiar with it and have slightly positive attitudes about it, their intentions to engage in it and their actual engagement are relatively low. Respondents who followed a course on the EBP process as a student are more oriented toward it than those who did not. Social workers under 29 are more familiar with the EBP process than those over 29.

CONCLUSIONS

We recommend educators to take a more active role in teaching the EBP process to students and social workers.

[Viral Infections Among the Nursing Personnel - a Survey]

BACKGROUND AND AIM

Healthcare workers (HCW) are at risk of occupational infections and can also transmit diseases to patients. The acceptance of measures to improve safety is linked to knowledge and risk awareness of HCW. The purpose of our study was to ascertain the knowledge and risk awareness of nursing staff regarding occupational infections and vaccinations as well as the frequency of needlestick injuries (NSI) in relation to the level of education.

METHODS

In the context of a conference on nursing, an anonymous questionnaire was distributed to the participants.

RESULTS AND CONCLUSIONS

Nursing staff had insufficient knowledge of viral occupational infections with regard to the actual hazard. At the same time, more than 60 % of the respondents rated the probability of contracting occupational infections as "pretty high" to "very high". In addition, 62.1 % of the study participants also stated that they did not feel sufficiently trained to care for patients with highly contagious or rare infectious diseases. Intensified training and awareness programs for nursing personnel are required to increase the knowledge of occupational infections.

What ' s in it for me? A managerial perspective on the influence of the psychological contract on attitude towards change

Purpose

– The purpose of this paper is to develop a model on how business managers perceive that an employee’s psychological contract influences his or her attitude toward an organizational change. More specifically, it aims to provide insight into the managerial views on: first, the affective, behavioral and cognitive responses of employees toward organizational change; second, the pre-change and change antecedents of these responses; and third, the role of the psychological contract as a pre-change antecedent.

Design/methodology/approach

– Data were collected from in-depth interviews with 39 human resource directors, change managers and management consultants in eight European countries. Based on detailed grounded theory-driven analyses of the qualitative data, a conceptual model was developed.

Findings

– Based on the grounded theory analysis, a model emerged that positions the individual change perception and individual answer to the “what’s in it for me?” question as central determinants of an employee’s attitude toward change. Moreover, the model distinguishes between “influencing” variables that shape the employees’ change perception, and “overruling” variables that can potentially reverse the change perceptions.

Practical implications

– A strong emphasis on managing the employment relationship by fulfilling mutual obligations and by creating trust will yield more constructive responses to organizational change than focussing on managing an organizational change as an independent event.

Originality/value

– As one of the first in its field, this study provides insight in the sense-making processes during organizational change, while adopting a managerial perspective. A grounded theory approach by means of interviewing, serves as a first step toward better understanding of the development of employees’ affective, behavioral and cognitive responses to organizational change.

Waarom willen gepensioneerden langer doorwerken?

In dit artikel wordt beschreven hoe toekomstperspectief en motieven van invloed zijn op de intentie tot langer doorwerken van 111 ouderen met een gemiddelde leeftijd van 66.7 jaar. Deze ouderen hebben ongeveer de leeftijd waarop ze de keuze maken om al dan niet door te werken na hun 65ste. Alle ouderen in deze studie staan ingeschreven bij een uitzendbureau en hebben derhalve aangegeven te willen doorwerken. Uit de resultaten blijkt dat meesterschap (het stellen van persoonlijke doelen en een oriëntatie om voortdurend taken beter te willen doen of beter te beheersen, zelfs als dat niet vereist wordt) positief gerelateerd is aan de intentie van deze ouderen om langer door te werken. Meesterschap medieert de relatie tussen toekomstperspectief en de intentie om langer door te werken en is ook verbonden met leergierigheid en de sociale context. Het stimuleren van meesterschap, in combinatie met het beïnvloeden van toekomstperspectief, leergierigheid en de sociale context, zou de intentie van ouderen tot langer doorwerken mogelijk kunnen verhogen.

[Preclinical duty of care during cuff pressure management]

BACKGROUND

Airway morbidity is influenced by different factors. Independent of the main emergency health problem, airway morbidity factors may exacerbate a possible poor outcome (e.g., bleeding, tongue swelling, nerve lesion).

OBJECTIVES

However, insertion technique and cuff pressure management are both important for duty of care out-of-hospital emergency medicine. After securing the airway (e.g., tracheal tube or supraglottic airway device cuff), pressure measurement is necessary.

MATERIALS AND METHODS

In a number of recent publications, a largely forgotten issue has come into the focus of preclinical science. This issue became particularly relevant in the admitting hospital.

RESULTS

The results from the aforementioned publications show that preclinical management of cuff pressure is not taken sufficiently into consideration, resulting in possible harm to the patient.

DISCUSSION

It is important and safe to use a cuff pressure device. The initial cuff pressure and if necessary corrected value should be documented.

Access to long-term care: perceptions and experiences of older Dutch people

Purpose

– Despite the current focus on demand-based care, little is known about what clients consider important when they have a request for formal long-term care services. The paper aims to discuss this issue.

Design/methodology/approach

– Questions about the access process to care services were added to the “Senior Barometer”, a Dutch web-based questionnaire that assesses the opinion of older people about different aspects in life. The questionnaire surveyed both people who already requested care services (“users”), and people that did not (“future clients”).

Findings

– The results show a significant difference in what people expect to be the first step from what users actually did, when requesting formal care services. In addition, there was a significant difference on how “users” and “future clients” rated several access service aspects.

Research limitations/implications

– The results give valuable information on how both “users” and “future clients” value the access process. The findings also provide valuable input for organizations providing long-term care for older clients about the important issues that have to be considered when organizing the access process.

Originality/value

– This study shows what older people in the Netherlands find important during the access process to care and this has not been explored before. The difference between what “users” and “future clients” find of importance in the care access process suggests that it is difficult for people to foresee what will be important once the need for care arrives, or where they will turn to with a request for care services.

Does a Well-Informed Employee Have a More Positive Attitude Toward Change? The Mediating Role of Psychological Contract Fulfillment, Trust, and Perceived Need for Change

This study examined the mediating role of psychological contract fulfillment, trust, and perceived need for change in the relationship between change information and employee attitude toward organizational change. As one of the first studies in organizational change research, attitude toward change was operationalized here as a tridimensional construct, comprising an affective, a behavioral, and a cognitive dimension. In a sample of 399 employees, data were gathered using questionnaires. The results confirmed that psychological contract fulfillment, trust, and perceived need for change mediated the relationship between change information and attitude toward change. Change information was positively related to all three mediating variables, which in turn were positively related to at least one of the attitude toward change dimensions. Furthermore, the relationship between trust and all three attitude toward change dimensions was mediated by psychological contract fulfillment and perceived need for change. Recommendations for future research and implications for practitioners are discussed.

Balanced versus Unbalanced Psychological Contracts in Temporary and Permanent Employment: Associations with Employee Attitudes

This study concerns balance in exchange relationships as described in the psychological contract literature about employees’ and employers’ promises and fulfilment of these promises. Balance is investigated, firstly, in relation to temporary versus permanent employment and, secondly, in relation to employees’ attitudes (fairness, job satisfaction, and intention to quit). Analyses were based on a Dutch sample of 290 temporary and 489 permanent workers. Regarding balance in mutual promises, we found that temporary workers were more likely to have psychological contracts with few mutual promises than permanent workers, while permanent workers were more likely to have psychological contracts with many mutual promises compared to temporary workers. Regarding balance in the fulfilment of promises, we found the opposite pattern, namely, that fulfilment was higher in temporary workers compared to permanent workers. Furthermore, only mutual high fulfilment of promises was associated with higher job satisfaction and fairness and with lower intentions to quit.

Refining case management for dementia using insights from operations management

Purpose

– Providers of healthcare services face increasing performance demands in terms of cost-efficiency as well as client centeredness. Dementia care is an illustrative example in this respect. Due to the aging society, the number of dementia clients is expected to grow significantly, which implies increasing costs. At the same time, demands in terms of coherent and high-quality care for dementia clients are increasing, putting a stronger emphasis on demand driven, responsive care and service processes. Literature shows that case management in dementia care is beneficial for persons with dementia and caregivers, but costly. Using insights from operations management (OM), the purpose of this paper is to develop a new model for case management in dementia care.

Design/methodology/approach

– To address both cost containment and customer orientation, insights from OM, in particular front/back office (FO/BO) configuration and modularity theory, are used to develop an innovative conceptual model for case management in dementia care.

Findings

– This framework offers a new way of conceptualizing care provision throughout the different phases of a chronic disease process. Linking FO/BO configurations and modular organizing with case management makes it possible to create a cost-effective and client-centered system of healthcare management.

Originality/value

– A new model is developed to address both cost containment and customer orientation based on insights from OM, in particular FO/BO configuration and modularity theory.

Mechanical properties of morcellised bone graft with the addition of hydroxyapatite

Mixtures of morcellised bone graft (MBG) and hydroxyapatite (HA) are frequently used in revision arthroplasty surgery. However, the changes in the mechanical properties from adding HA to MBG are unknown. This study used a uniaxial compression test to replicate impaction bone grafting and subsequent early postoperative weightbearing to investigate the effect of adding different proportion of HA to MBG. To achieve this aim, human MBG was subjected to increasing impaction forces and the apparent stiffness and creep for each stress level determined. Subsequently, increasing proportions porous and non porous HA were added to the MBG. The major findings were that the apparent stiffness for MBG increased and the associated creep decreased both with the application of increasing stress and with the addition of increasing proportions of HA. In conclusion, greater proportions of HA in the graft mixture improved the mechanical response compared with MBG impacted under the same force. This improvement replicated the properties of pure MBG under high axial stress. This study indicates that graft mixtures of MBG and HA can be tailormade for patients. The need for less impaction force in MBG:HA mixtures to obtain the same properties as pure MBG may decrease the risk of intraoperative fracture.

How to coordinate care for people with dementia? A case study of a region in the Netherlands

The greying of the population and trends that will change the future institutional context have implications for the social care for people with dementia and their caregivers. Based on the data of services provided by 50 organisations in a region in the South of the Netherlands, an organisational analysis revealed that better coordinated care is needed to fit the changing needs of clients in different phases of the disease process.

[Taking over a patient with preclinical laryngeal tube]

Endotracheal intubation (ETI) is the most effective method for securing the airway. However, the practice and theory of ETI differ considerably. There is a wide gap between reality and the optimum of quality and quantity required by many specialist organizations, e.g., the European Resuscitation Council. Alternative airway devices, such as a laryngeal tube, can be useful provided the hospital staff know how the device functions and how to avoid or control complications.

Waar is de Organisatie in Gedrag & Organisatie?

Where is the organization in Organizational Behavior?

This article discusses why it is of increasing importance for researchers to pay attention to the organization as context factor. It is described what context is, how the context can influence results, and how attention can be paid to the influence of the organization context.

Age-related attitudes: the influence on relationships and performance at work

PURPOSE

This paper aims to examine the influence of age and age-related attitudes on relationship factors. In addition, it seeks to assess how both factors affect care service work performance.

DESIGN/METHODOLOGY/APPROACH

The paper explores the influence of age and age-related attitudes on the relationship quality among employees, affecting performance in mentally and physically demanding work settings. The authors conducted the research in six residential homes for the elderly in Germany (152 respondents) and collected the data with questionnaires. Data are analyzed by multi-hierarchical regression analyses.

FINDINGS

Results show that age-related attitudes (intergenerational cooperation and the perception of older employees' capabilities) are important factors influencing the perceived quality level of in-group cooperation. Both age-related attitudes and relationship factors influence perceived employee performance, and job satisfaction.

RESEARCH LIMITATIONS/IMPLICATIONS

The findings contribute to understanding how age-related attitudes influence relationships among employees, the relationship between employees and supervisor, and the effect on service performance. The mono-cultural sample might be a limitation, as well as the composition of the sample: The majority of respondents were female.

PRACTICAL IMPLICATIONS

For leaders, supervisors and managers the results contribute to understanding how employees' age-related attitudes, in mentally and physically demanding work settings, influence the quality level of relationships and outcomes. This is relevant in the context of leaders/supervisors promoting followers' individual development and group/team development.

ORIGINALITY/VALUE

The paper shows that in care service work with an increasing number of older employees, the positive perception of age-related attitudes influences relationship quality and performance positively.

[Implementation of the laryngeal tube for prehospital airway management: training of 1,069 emergency physicians and paramedics]

OBJECTIVE

The European Resuscitation Council recommends that only rescuers experienced and well-trained in airway management should perform endotracheal intubation. Less trained rescuers should use alternative airway devices instead. Therefore, a concept to train almost 1,100 emergency physicians (EP) and emergency medical technicians (EMT) in prehospital airway management using the disposable laryngeal tube suction (LTS-D) is presented.

METHODS

In five operational areas of emergency medicine services in Germany and Switzerland all EPs and EMTs were trained in the use of the LTS-D by means of a standardized curriculum in the years 2006 and 2007. The main focus of the training was on different insertion techniques and LTS-D use in children and infants. Subsequently, all prehospital LTS-D applications from 2008 to 2010'were prospectively recorded.

RESULTS

None of the 762 participating EMTs and less than 20% of the EPs had previous clinical experience with the LTS-D. After the theoretical (practical) part of the training, the participants self-assessed their personal familiarity in using the LTS-D with a median value of 8 (8) and a range of 2-10 (range 1-10) of 10 points (1: worst, 10: best). Within the 3-year follow-up period the LTS-D was used in 303 prehospital cases of which 296 were successfully managed with the device. During the first year the LTS-D was used as primary airway in more than half of the cases, i.e. without previous attempts of endotracheal intubation. In the following years such cases decreased to 40% without reaching statistical significance. However, the mean number of intubation attempts which failed before the LTS-D was used as a rescue device decreased significantly during the study period (2008: 2.2 ± 0.3; 2009: 1.6 ± 0.4; 2010: 1.7 ± 0.3).

CONCLUSION

A standardized training concept enabled almost 1,100 rescuers to be trained in the use of an alternative airway device and to successfully implement the LTS-D into the prehospital airway management algorithm. Because the LTS-D recently became an accepted alternative to endotracheal intubation in difficult airway scenarios, the number of intubation attempts before considering an alternative airway device is steadily decreasing.

Stoppen of doorgaan?

Continuing work or retiring? An introduction to theory and practice of retirement in the Netherlands

The topic of this special issue on retiring or continuing work among older employees is introduced. In addition to an overview of relevant Dutch retirement legislation and statistics on retirement in the Netherlands, we pay attention to the operationalisation of retirement and highlight important psychological perspectives and theories on the topic of retirement. Furthermore, we summarize the theoretical and empirical findings of earlier research on retirement. Finally, we discuss the seven contributions of this special issue and formulate a research agenda.

Flexicurity gemeten. Een vragenlijst over flexibiliteit en zekerheid voor organisatie en werknemer

Flexicurity assessed. A questionnaire for organizational and employee flexibility and security

Gedrag & Organisatie, volume 24, September 2011, nr. 3, pp. 286-303.Flexicurity, the balance between security and flexibility, is an important theme in Human Resource Management in Europe for employers as well as employees (Freese, Paauwe & Schalk, 2009). A questionnaire was developed to assess perceptions of employees on security and flexibility, a Dutch version of an original Swiss instrument (Raeder, Wittekind, Inauen & Grote, 2009). Data of two studies are used to examine the structure of the questionnaire with confirmatory factor analysis. In addition, hypotheses on the influence of on the one hand expected and offered flexibility and security, and on the other hand commitment, turnover intention, leadership perceptions and life satisfaction are tested. The structure of the questionnaire was confirmed. The results support the expected effects of perceptions of flexibility and security on commitment, turnover intention, leadership perceptions, and life satisfaction. Using the instrument can help organizations to adapt or innovate their HR policies.

The influence of organizational commitment and health on sickness absenteeism: a longitudinal study

BACKGROUND

The prevention of sickness absenteeism of nurses is an important issue for organizations in health care as well as for nurses. The role of work-related attitudes, such as organizational commitment, as a cause of absenteeism is still unclear.

OBJECTIVES

To examine the influence over time of organizational commitment, health complaints, and visits to a general practitioner on sickness absenteeism.

DESIGN AND PARTICIPANTS

This was a longitudinal, three-wave study in two nursing homes in the Netherlands among 224 nurses.

METHODS

Questionnaire data (self reports of organizational commitment, health complaints, visits to a general practitioner), as well as absenteeism data retrieved from personnel files was used.

RESULTS

Health complaints and visits to a general practitioner were found to predict absenteeism behaviour. Commitment was related to health complaints at the same point in time, but did not predict future sickness absenteeism.

IMPLICATIONS FOR NURSING MANAGEMENT

With respect to managing sickness absenteeism of nurses it should be acknowledged by managers that nurses call in sick when they perceive that there is a real health problem, not because of negative work attitudes. It is important, however, for managers to signal signs of decreasing organizational commitment because this is associated with increases in health complaints. This can eventually result in increases in absenteeism.

Tracheal intubation using the mobile C-MAC video laryngoscope or direct laryngoscopy for patients with a simulated difficult airway

BACKGROUND

Several studies have shown that video laryngoscopy enhances the laryngeal view in patients with apparently normal and anticipated difficult airways. The utility of the novel, portable, battery-powered C-MAC video laryngoscope is unproven, but its design makes it potentially useful for emergency situations. We hypothesized that, in patients with a simulated difficult airway created by means of a rigid cervical immobilization collar, the rate of glottic views considered "failed" under direct laryngoscopy could be significantly reduced with the C-MAC video laryngoscope.

METHODS

Following power analysis and ethical approval, 43 adults undergoing surgery under general anesthesia were studied. First, direct laryngoscopy was performed with the naked eye with and without applying external laryngeal pressure (BURP maneuver). The best-obtained view was graded by the laryngoscopist without looking at the video monitor. A second anesthesiologist, who was blinded to the laryngeal view obtained under direct laryngoscopy, graded the laryngeal view on the video monitor. A difficult airway was then created and the laryngoscopy sequence repeated. Endotracheal intubation was then attempted under video-aided visualization.

RESULTS

In patients with a normal airway, the glottic view was considered as "good" in the vast majority of patients (40-43/43; 93-100%) regardless of the laryngoscopy technique used. When a difficult airway was created, the glottic view was graded as "failed" in 30/43 (70%) and 16/43 (37%) of patients under direct laryngoscopy without and with the BURP maneuver, respectively (P=0.0047). Using video laryngoscopy, significantly fewer laryngoscopic views were graded as "failed" without (14%, P<0.0001) and with the BURP maneuver (5%, P=0.0003) compared to direct laryngoscopy. Endotracheal tube placement was successful in 88% of patients with a difficult airway.

CONCLUSION

The C-MAC video laryngoscope effectively enhanced the laryngeal view in patients with limited inter-incisor distance and eliminated cervical spine clearance. However, endotracheal tube placement failed in 5/43 patients despite a mostly good laryngeal view.

A Sensemaking Model of Employee Evaluation of Psychological Contract Fulfillment

There is growing attention in the academic literature and popular press regarding workplace transitions. Change is frequently mentioned as a defining quality of the new workplace and, in turn, employment relationships. A framework is presented that describes employee evaluation of the employment relationship in the context of change. Specifically, the authors apply psychological contract and sensemaking theories to address two questions: What contextual factors shape employee perceptions of change in psychological contract fulfillment? and What cognitive factors shape employee responses to perceptions of deficiency in psychological contract fulfillment? The authors’ aim is to enhance understanding of employment relationships in the context of organizational change and stimulate empirical research that treats change context as a substantive variable. The authors discuss theoretical and practical implications of the framework. Recommendations for practitioners engaged in organizational change are offered.

De Tilburgse Psychologisch Contract Vragenlijst

The Tilburg Psychological Contract Questionnaire

C. Freese, R. Schalk & M. Croon, Gedrag & Organisatie, volume 21, August 2008, nr. 3, pp. 278-294.

The development of the Tilburg Psychological Contract Questionnaire (TPCQ) is described. Criteria are formulated that psychological contract measures should meet. The theoretical background and the psychological contract items of the TPCQ are described. With exploratory factor analysis five perceived organizational obligation scales are revealed: job content, career development, social atmosphere, organizational policies and rewards. Two perceived employee obligation scales were found: in-role behaviour and extra-role behaviour. A separate violations scale was developed. The psychometric features of the scales (including test-retest reliability) were sufficient. Construct validity was assessed with regression analysis on affective commitment, continuance commitment and intention to turnover. Organizational policies, violations and both perceived employee obligations scales were predictors of affective commitment, intention to turnover and to a lesser extent continuance commitment.

How to Measure the Psychological Contract? A Critical Criteria-Based Review of Measures

In this article we analyse the different ways in which psychological contracts are measured. On the basis of criteria for measurement and scale development psychological contract measurements are put to a test. The criteria are related to the way the measurement is developed and evaluated, and the specific conceptualisations of the content and evaluation of the psychological contract. Existing questionnaires to measure the psychological contract are evaluated. The use of psychological contract measurements of Freese and Schalk, Psycones, or Rousseau is recommended.