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Empowerment offers the predominant explanation for why employee perceptions of high-performance managerial practices are positively associated with employee job performance. Drawing on social cognitive theory, we propose that high-performance managerial practices also influence performance because these practices encourage employees to engage in voice. Additionally, we suggest that empowerment and voice together provide a more complete explanation for why high-performance managerial practices and job performance are linked. In essence, we argue that empowerment transmits the effects of high-performance managerial practices to job performance because it engenders voice. Using meta-analysis of primary research consisting of 151 independent samples involving 53,200 employees, we find that not only do empowerment and voice independently transmit the effects of high-performance managerial practices to job performance, but they sequentially mediate this relationship as well. Further, we distinguish among skill-enhancing, motivation-enhancing, and opportunity-enhancing high-performance managerial practices to identify when empowerment and voice are more or less effective in explaining associations with job performance. Although empowerment and voice transmit effects of all 3 types of high-performance managerial practices to employee performance, these mechanisms appear to provide the best explanation for the effects of opportunity-enhancing practices, and the primary reason why is because employees respond to opportunity-enhancing practices with voice.

Employees are directly involved in work tasks and processes which are necessary to accomplish unit or organizational goals, and accordingly, they may become aware of key mistakes, slips, and failures that are unbeknownst to the leader or supervisor responsible for the work unit or organization. Given that errors or deviations in work tasks or processes can have far-reaching effects within the organization, it may be essential for employees to share bad news with their leader or supervisor so that steps can be taken to address the issue or ameliorate negative consequences. However, although employees' sharing of bad news may be important to the organization and should be encouraged, supervisors may respond to the messenger in ways that discourage the behavior. Unfortunately, we lack an explanation of why and under what conditions supervisors respond positively or negatively to employees who share bad news. Thus, the purpose of this dissertation is to address this gap in our understanding. I draw from social exchange theory and the transactional theory of stress to develop a conceptual model of sharing bad news. I suggest that sharing bad news can be cast as a transaction between employees and supervisors that is mediated by supervisors’ appraisals of employees’ sharing the message. The quality of the relationship between an employee and supervisor, or leader-member exchange (LMX), is strengthened when supervisors appraise the sharing of bad news as challenging, or potentially rewarding; however, LMX is weakened when supervisors appraise the sharing of bad news as hindering, or potential harmful. In turn, LMX influences supervisor responses to the sharing of bad news in the form of evaluations of the employee’s effectiveness. In addition to these main effects, I also consider how aspects of the message delivery, such as the timeliness with which messages are conveyed and extent to which employees incorporate solutions when they share bad news, can influence supervisor appraisals of sharing bad news. Finally, I suggest that the extent to which the messenger is responsible for the bad news moderates the relationships between appraisals of sharing bad news and LMX. I test this model in three studies.

Purpose The COVID-19 pandemic has increased moral distress and injury (MD&I) among healthcare workers (HCWs) and has highlighted a need for intervention. Most MD&I interventions have been with service members and veterans; only five have been empirically tested. Further, with the Defense Health Agency calling for civilian HCWs to provide care for military members, it is necessary to adapt an MD&I intervention that has been shown successful. Recent Findings Building Spiritual Strength (BSS), one of the five evidence-based MD&I interventions, was adapted for HCWs and renamed Health and Strength (HAS). The changes of the BSS to HAS are described. Summary HCWs are struggling with MD&I, and an intervention is needed. An already successful MD&I intervention for veterans, BSS is adapted for HCWs.

The go-to handbook on the current evaluation and surgical management of spinal disorders Handbook of Spine Surgery, Third Edition edited by renowned spine surgeons Ali A. Baaj, Praveen V. Mummaneni, Juan S. Uribe, Alexander R. Vaccaro, and Mark S. Greenberg reflects new techniques introduced into the practice since publication of the last edition, along with four-color images and videos. The book is organized into four parts and 66 chapters, starting with basic spinal anatomy. Part II covers the physical exam, electrodiagnostic testing, imaging, safety issues, intraoperative monitoring, bedside procedures, and the use of orthotics, pharmacology, and biologics. Part III discusses a full range of spinal pathologies and the final section concludes with 34 succinct procedural chapters. Key Highlights * Contributions from an expanded \"who's who\" of spine surgery experts * New chapters cover state-of-the-art techniques, including endoscopy, CT-guided navigation, robotics, augmented reality, and vertebral body tethering * Procedural chapters include key points, indications, diagnosis, preoperative management, anatomic considerations, techniques, surgical pearls, and more This is an invaluable resource for neurosurgical and orthopaedic residents, spinal surgical fellows, and practicing orthopaedic surgeons and neurosurgeons who specialize in spine surgery.

BackgroundWeight gain and other metabolic sequelae of antipsychotic medications can lead to medication non-adherence, reduced quality of life, increased costs, and premature mortality. Of the approaches to address this, behavioral interventions are less invasive, cost less, and can result in sustained long-term benefits.ObjectiveWe investigated behavioral weight management interventions for veterans with mental illness across four medical centers within the Veterans Affairs (VA) Healthcare System.DesignWe conducted a 12-month, multi-site extension of our previous randomized, controlled study, comparing treatment and control groups.ParticipantsVeterans (and some non-veteran women) diagnosed with mental illness, overweight (defined as having a BMI over 25), and required ongoing antipsychotic therapy.InterventionsOne group received “Lifestyle Balance” (LB; modified from the Diabetes Prevention Program) consisting of classes and individual nutritional counseling with a dietitian. A second group received less intensive “Usual Care” (UC) consisting of weight monitoring and provision of self-help.Main MeasuresParticipants completed anthropometric and nutrition assessments weekly for 8 weeks, then monthly. Psychiatric, behavioral, and physical assessments were conducted at baseline and months 2, 6, and 12. Metabolic and lipid laboratory tests were performed quarterly.Key ResultsParticipants in both groups lost weight. LB participants had a greater decrease in average waist circumference [F(1,1244) = 11.9, p < 0.001] and percent body fat [F(1,1121) = 4.3, p = 0.038]. Controlling for gender yielded statistically significant changes between groups in BMI [F(1,1246) = 13.9, p < 0.001]. Waist circumference and percent body fat decreased for LB women [F(1,1243) = 22.5, p < 0.001 and F(1,1221) = 4.8, p = 0.029, respectively]. The majority of LB participants kept food and activity journals (92%), and average daily calorie intake decreased from 2055 to 1650 during the study (p < 0.001).ConclusionsBehavioral interventions specifically designed for individuals with mental illness can be effective for weight loss and improve dietary behaviors. “Lifestyle Balance” integrates well with VA healthcare’s patient-centered “Whole Health” approach.ClinicalTrials.gov identifier NCT01052714.

Veterans with mental illness tend to have shorter life spans and suboptimal physical health because of a variety of factors. These factors include poor nutrition, being overweight, and smoking cigarettes. Nonphysical contributors that may affect quality of life are the stigma associated with mental illness, social difficulties, and spiritual crises. Current mental health treatment focuses primarily on the delivery of medication and evidence-based psychotherapies, which may not affect all the above areas of a Veteran's life as they focus primarily on improving psychological symptoms. Clinicians may find greater success using integrative, comprehensive, multifaceted programs to treat these problems spanning the biological, psychological, social, and spiritual domains. These pilot studies test an adjunctive, holistic, behavioral approach to treat mental illness. This pilot work explores the hypotheses that engagement in a greater number of therapeutic lifestyle changes (TLCs) leads to improvement in quality of life, reduction of psychiatric symptoms, and weight loss. Institutional Review Boards for human subjects at the Veterans Affairs (VA) Greater Los Angeles and Long Beach Healthcare Systems approved pilot study activities at their sites. Pilot Study 1 was a prospective survey study of Veterans with mental illness, who gained weight on an atypical antipsychotic medication regimen, participating in a weight management study. At each session of the 1-year study, researchers asked a convenience sample of 55 Veterans in the treatment arm whether they engaged in each of the eight TLCs: exercise, nutrition/diet, stress management and relaxation, time in nature, relationships, service to others, religious or spiritual involvement, and recreation. Pilot Study 2 applied the TLC behavioral intervention and examined 19 Veterans with mental illness, who attended four classes about TLCs, received individual counseling over 9 weeks, and maintained journals to track TLC practice. Besides weekly journals, researchers also collected prospective data on quality of life, psychiatric symptoms, vitals, and anthropometric measurements. In both studies, investigators tested for main effects of the total number of TLCs practiced and study week using mixed-effects linear models with independent intercepts by participant. In Study 1, engagement in more TLC behaviors was significantly associated with higher ratings of quality of life, as well as greater weight loss for each additional type of TLC practiced. In Study 2, TLC practice increased significantly over 9 weeks, and was significantly associated with improvements in quality of life and diastolic blood pressure. Counseling Veterans to practice TLCs provides a holistic adjunct to current treatments for mental illness. TLCs may confer multiple benefits upon Veterans with mental illness, enhancing quality of life and well-being along with weight management efforts. As these were pilot studies, the samples sizes were relatively small and a control group was lacking. Our findings may have broader implications supporting a holistic approach in both primary and mental health care settings. Future research will expand this work to address its weaknesses and examine the cost differential between this holistic approach and traditional mental health treatment.

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Despite adjuvant treatment with endocrine therapies, estrogen receptor-positive (ER+) breast cancers recur in a significant proportion of patients. Recurrences are attributable to clinically undetectable endocrine-tolerant persister cancer cells that retain tumor-forming potential. Therefore, strategies targeting such persister cells may prevent recurrent disease. Using CRISPR-Cas9 genome-wide knockout screening in ER+ breast cancer cells, we identified a survival mechanism involving metabolic reprogramming with reliance upon mitochondrial respiration in endocrine-tolerant persister cells. Quantitative proteomic profiling showed reduced levels of glycolytic proteins in persisters. Metabolic tracing of glucose revealed an energy-depleted state in persisters where oxidative phosphorylation was required to generate ATP. A phase II clinical trial was conducted to evaluate changes in mitochondrial markers in primary ER+/HER2-breast tumors induced by neoadjuvant endocrine therapy ( NCT04568616 ). In an analysis of tumor specimens from 32 patients, tumors exhibiting residual cell proliferation after aromatase inhibitor-induced estrogen deprivation with letrozole showed increased mitochondrial content. Genetic profiling and barcode lineage tracing showed that endocrine-tolerant persistence occurred stochastically without genetic predisposition. Mice bearing cell line- and patient-derived xenografts were used to measure the anti-tumor effects of mitochondrial complex I inhibition in the context of endocrine therapy. Pharmacological inhibition of complex I suppressed the tumor-forming potential of persisters and synergized with the anti-estrogen fulvestrant to induce regression of patient-derived xenografts. These findings indicate that mitochondrial metabolism is essential in endocrine-tolerant persister ER+ breast cancer cells and warrant the development of treatment strategies to leverage this vulnerability in the context of endocrine-sensitive disease. Endocrine-tolerant persister cancer cells that survive endocrine therapy can cause recurrent disease. Persister cells exhibit increased energetic dependence upon mitochondria for survival and tumor re-growth potential.

Awarded Best Paper, Biometrics, Forensics, and Physical Security Track Self-curing polysiloxane polymers have been developed for the forensic collection of latent signatures of explosives, organophosphates, and chemical warfare agent (CWA) degradation products. These polymeric materials penetrate the sample substrate as viscous liquids and subsequently harden to a semi-soft solid that can be peeled away from the substrate to extract signatures via the non-covalent interaction of the newly formed polymeric material with the analytes buried within the substrate. This paper discusses experiments aimed at altering the chemical and physical properties of the polysiloxane sampling materials to optimize signature recovery from porous substrates. The utility of this approach is demonstrated by the collection of target analytes from within concrete. The recovery of these signatures using the self curing polymeric formulations is compared to current operational sampling alternatives such as adhesive fingerprint lifters and swabs. Demonstration of the preparation, extraction, and analytical methods for the detection of the target analytes is also presented. [PUBLICATION ABSTRACT]