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Elephants before unicorns : emotionally intelligent HR strategies to save your company
\"Elephants Before Unicorns is for overcoming \"elephant\" obstacles and building your perfect \"unicorn\" company culture. Bringing her expertise from HR to EQ, Caroline Stokes offers business owners the actionable strategies they need to gain and retain a quality workforce\"-- Provided by publisher.
Book
Correction: Martellos et al. Volunteers Recruitment, Retention, and Performance during the CSMON-LIFE (Citizen Science MONitoring) Project and 3 Years of Follow-Up. Sustainability 2021, 13, 11110
In the original publication [...]
Journal Article
Postpartum urinary retention: what are the sequelae? A long-term study and review of the literature
Introduction and hypothesisPostpartum urinary retention (PUR) may cause long-term urogenital tract morbidity. The incidence ranges from 0.18 to 14.6%, but the importance of prompt diagnosis and appropriate management is often underappreciated. The paucity of data on long-term outcome after PUR contributes to these drawbacks. The aim of this study was to assess long-term persistence of elevated PVR (post-void residual urine) volume after PUR. Pathophysiology, risk factors and management of PUR are reviewed.MethodsIn our tertiary referral urogynecology unit in the University Women’s Hospital of Bern, Switzerland, all patients who were referred for PUR were asked to participate in this study. PVR was measured sonographically every 2 days until day 15, then after 6, 12, 24 and 36 months and, if increased, the patients were instructed to perform clean intermittent self-catheterization. If retention persisted longer than the lactation period, multichannel urodynamics was performed.ResultsSixty-two patients were included. The median PVR normalized at day 7. Long-term voiding disorders were found in 8.2%, 6.7%, and 4.9% after 1, 2, and 3 years respectively. Multichannel urodynamics confirmed in all patients with persisting retention an acontractile detrusor and de novo stress urinary incontinence in 4 cases. Quantile regression did not reveal any factor contributing to earlier recovery. Eighty-nine percent of the patients with PUR had operative vaginal deliveries, emphasizing the importance of this risk factor for PUR.ConclusionsIn most cases PUR resolves early, but voiding difficulties persist more often than previously thought, and for these patients the consequences are devastating. Obstetric awareness, early active management, and developing management strategies in the postpartum period might preclude lower urinary tract morbidity.
Journal Article
Does Retention of Fibula in Transfibular Approach Leads to Complication?
Category:
Ankle, Ankle Arthritis, Hindfoot
Introduction/Purpose:
A variety of operative approaches and fixation techniques have been described for tibiotalar (TT) and tibiotalocalcaneal (TTC) arthrodesis. In the past two decades, authors have begun to more robustly examine outcomes of the transfibular approach for TT arthrodesis and expanded its indication to include TTC fusion. The transfibular technique is broadly divided into two categories: 1) Complete excision of fibula 2) Soft tissue preservation techniques with retention of fibula. The purpose of this study was to retrospectively assess the surgery outcomes in transfibular approach and compare the fibula excision versus fibula retention techniques and examine the factors that play into the risk.
Methods:
Following institutional review board approval, a retrospective review was performed on all patients who underwent TT and TTC arthrodesis through a lateral transfibular approach with minimum 1 year clinical and radiologic follow up. All other operative approach and fixation combinations for arthrodesis were excluded. Primary outcomes examined were union rate, revisions, and complications related to fibula excision versus retention group. Sixteen patients underwent TT and TTC arthrodesis with fibular retention and twelve with fibular excision techniques.
Results:
The overall union rate was 89%, 87% (14 of 16 ankles) for the fibula retention group, and 91% (11 of 12) for fibula excision group (P = .72). Symptomatic nonunion requiring revision arthrodesis occurred in 6% (1 of 16) of the retention group versus 8% (1 of 12) in the excision group (P = .83). There were no significant differences in individual tibiotalar or subtalar union, reoperation, superficial wound problems, infection and symptomatic hardware rates. Elective hardware removal was performed in 12%(2of 16) in fibular retention group versus 25%(3 of 12) in fibula excision group (P = .39), none of the hardware removal was related to the fibula fixation. Each group had three episodes of reoperation due to non-union, osteomyelitis and painful hardware.
Conclusion:
Union, reoperation rates were similar in fibula resection versus retention groups. The frequency of infection and wound complication was not significantly different in both groups, despite the wide variety of patient population and preoperative indications.
Journal Article
MENTORSHIP RELATIONSHIPS FOR THE FIRST INDEPENDENT YEAR CAN HELP WITH NURSING RETENTION
Significance & Background: Data shows that new graduates experience \"reality shock\" within the first few months on their own and in environments like the ICU which can deter nurses from the bedside leading to poor staff retention. We designed a mentorship program called \"The Buddy System\" to create an environment that supports new graduates. With the focus to increase new graduate retention at the one-and two-year mark. Purpose: To generate a supportive environment and relationship with the new graduates on the unit. Each new graduate selects a mentor of their choosing, to be an experienced resource for their first independent year. This provides a personal approach to assist the mentee with questions, concerns, issues with assignments, conflicts with staff, and more. The hope is that this relationship will help create a supportive environment that aids in staff retention. Interventions: Each new graduate chooses a more senior nurse as their mentor from a list of mentor volunteers. If the mentor is not on the list, the coordinators reach out to that nurse to determine interest in mentoring. The mentor and mentee are given tips, guidelines, and expectations before starting the relationship. They have weekly check ins, and quarterly meet ups to discuss their progress in the program. The coordinators check in with them every couple of months to address any concerns they may have. Surveys are sent at the beginning, middle, and end of the program to assess learning needs, comfort levels, and progress being made. Results: The first group in this program had 100% retention at the end of their first year and 75% retention after two years. The two that left moved on to further their education. The second group had 83% retention after the first year. One person left to further their education and one left to go to a different field of nursing. Discussion: This program is still in its early years, but the data has shown it to be effective. The nurses that left did so for reasons unrelated to the unit. Our initiative has shown that having a mentor your first year helps with comfort and unit cohesion. This leads to staff retention at the one- and two-year mark.
Journal Article