Work-Family Enrichment: Influence of Job Autonomy on Job Satisfaction of Knowledge Employees.

In order to explore the specific path of the influence of job autonomy on the satisfaction of knowledge employees, the current study deduced and established a Chain Mediation Model, which was based on the Resource-Gain-Development Model and the Conservation of Resources Theory. Primary data were gathered through questionnaire surveys at several cities in China by using a professional platform named "Wenjuanxing." The target populations were employees with a bachelor's degree or above, who were engaged in higher knowledge content and have mastered certain professional knowledge and skills, including technical R & D personnel, management personnel, professionals (such as accountants, lawyers, and medics) and other personnel generally recognized by the academic community. In order to improve the reliability of the sample and reduce the error caused by regional differences, the questionnaires were disseminated to involve as many cities in China as possible, such as Tianjin, Beijing, Chengdu, Wuhan, and Guangzhou. SPSS24.0 and Aoms24.0 were used as multivariate data analysis tools for statistical analysis. The results showed that job autonomy can significantly improve the satisfaction of knowledge employees; however, it cannot affect the satisfaction of knowledge employees through self-efficacy. The findings of the study also revealed that job autonomy has a positive impact on both resource source domain satisfaction and resource acceptance domain satisfaction through work-family enrichment, especially the positive emotions in the resource source domain. Job autonomy improves the self-efficacy of knowledge employees, which, in turn, improves their overall satisfaction through the work-family enrichment path.

Dual adjunct therapy with dexamethasone and dexmedetomidine in transversus abdominis plane blocks reduces postoperative opioid use in colorectal surgery.

BACKGROUND: The objective of this study is to determine if the addition of dexmedetomidine to dexamethasone in transversus abdominis plane (TAP) blocks lowers postoperative opioid use following colorectal surgery. METHODS: Retrospective review of patients undergoing minimally invasive colorectal surgery and perioperative TAP block with either 1) local anesthetic and dexamethasone or 2) local anesthetic, dexamethasone, and dexmedetomidine. Post-operative opioid use was converted to morphine milligram equivalents (MME). RESULTS: 55 patients were identified: 38 (69%) receiving dexamethasone only and 17 (31%) receiving dexamethasone and dexmedetomidine. The dexamethasone and dexmedetomidine group had significantly lower median MME use at 12-h (2 vs. 13 mg), 24-h (4 vs. 28 mg), 36-h (8 vs. 38 mg), and 48-h (17 vs. 53 mg) (all p < 0.05). There was no difference at 72-h. CONCLUSION: Perioperative TAP blocks with dexamethasone and dexmedetomidine following colorectal surgery results in significantly less postoperative opioid use up to 48 h after surgery.

A single-center retrospective review of postoperative infectious complications in the surgical management of mandibular fractures: Postoperative antibiotics add no benefit.

BACKGROUND: Mandibular fractures are common facial injuries and treatment may be complicated by post-operative infection. Risk of infection from contamination with oral flora is well established but no consensus exists regarding antibiotic prophylaxis. The purpose of this study is to assess risk factors and perioperative antibiotics on surgical site infection (SSI) rates following mandibular fracture surgery. METHODS: Retrospective medical record review was completed for trauma patients of any age surgically treated for mandibular fractures at a Level I Trauma Center from September 2006 to June 2012. Outcomes analysis was performed to determine SSI rates related to perioperative antibiotic use and other risk factors that may contribute to SSI. RESULTS: 359 patients met inclusion criteria for analysis. 76% were male. Mean age was 30.5 years. Thirty-eight patients developed SSI (10.6%). SSI rate was lower in closed versus open surgery (3.2% vs. 16.3%, p=0.0001), and in closed versus open fractures (1% vs. 14%, p=0.0005). SSI rate increased in patients with tobacco, alcohol, and drug use (14.6%, 13.2%, 53.6%, p<0.0001), traumatic dental injuries (19.6%, p=0.0110), and patients in motor vehicle crashes (12.2%, p=0.0062). SSI rates stratified by Injury Severity Score (ISS) less than or equal to 16 (23/255 [9%]) versus ISS greater than 16 (15/104 [14%]) trended toward more severely injured patients developing SSI, p=0.1347. SSI rate was similar in patients who did and did not receive post-operative antibiotics (14.7% vs. 9.6%, p=0.2556). Type of antibiotic, duration of post-operative antibiotic administration, and duration between injury and surgery did not effect SSI rate. CONCLUSIONS: Findings suggest that following surgical treatment of mandible fractures, open surgery, open fractures, and risk factors including substance abuse, traumatic dental injury, and mechanism of injury significantly increase SSI rates, while post-operative antibiotics do not appear to provide additional benefit compared to pre-operative antibiotics alone. LEVEL OF EVIDENCE: Therapeutic study, level IV.

Disclosure and documentation of reported unanticipated medical events or outcomes: need for healthcare provider education.

In 2001 the Joint Commission on Accreditation of Healthcare Organizations added "requirement to disclose unanticipated outcomes" to accreditation standards. Full disclosure increases patient satisfaction and trust in physicians. Though studies suggest elements of complete disclosure, there are no national standards.

Light scatter on the surface of AcrySof intraocular lenses: part II. Analysis of lenses following hydrolytic stability testing.

BACKGROUND AND OBJECTIVE: To investigate the surface light scatter and optical quality of AcrySof lenses (Alcon Laboratories, Inc., Fort Worth, TX) following simulated aging of 20 years. MATERIALS AND METHODS: AcrySof lenses were exposed to exaggerated thermal conditions to simulate up to 20 years of aging and were tested for surface light scatter and optical quality (modulation transfer function). RESULTS: There were no significant differences from baseline for either the surface light scatter or optical quality of the lenses over time. CONCLUSION: The current study demonstrated that surface light scatter on AcrySof lenses did not increase under conditions simulating 20 years of aging. Because the simulated aging environment contained no protein, this work indirectly supports the finding that surface light scatter is due to the deposition of a biomaterial on the lens surface rather than changes in the material. Optical performance integrity of the test lenses was maintained under severe environmental conditions.

Light scatter on the surface of AcrySof intraocular lenses: part I. Analysis of lenses retrieved from pseudophakic postmortem human eyes.

BACKGROUND AND OBJECTIVE: To investigate the cause of light scatter measured on the surface of AcrySof intraocular lenses (Alcon Laboratories, Inc., Fort Worth, TX) retrieved from pseudophakic postmortem human eyes. MATERIALS AND METHODS: Ten intraocular lenses (Alcon AcrySofModel MA60BM) were retrieved postmortem and analyzed for light scatter before and after removal of surface-bound biofilms. RESULTS: Six of the 10 lenses exhibited light scatter that was clearly above baseline levels. In these 6 lenses, both peak and average pixel density were reduced by approximately 80% after surface cleaning. CONCLUSION: The current study demonstrates that a coating deposited in vivo on the lens surface is responsible for the light scatter observed when incident light is applied.