Rationale, aims and objectives: Appropriate use of diagnostic and treatment modalities are essential for rational use of resources. The aim of this study is to evaluate the use of diagnostic modalities and different treatment options and their economic impacts following an acute ankle distortion resulting from an occupational accident. We evaluated the type-of-treatment impact on the victims' course of recovery as well as its impact on the associated accident costs. Research was carried out in Belgium. Methods: An ankle distortion victims' (...) database consisting of 200 cases of (Belgian) occupational accidents during the period 2005-2007 was analysed. Results: Patients who were prescribed immobilization or the use of adjuvant support or physical therapy (118 cases) were not employed during a period of 37 days on average, with a mean total cost of 3140.14 Euros caused by the ankle sprain. Patients without any adjuvant therapy (82 cases) were characterized by an unemployment rate of 15 days on average, and a total cost of 1077.86 Euros. Cast immobilization, although its application is not supported by evidence-based literature, was still applied in 36% of the population studied and resulted in the longest average absence of work of 42 days with an obvious significant increase in medical and total costs. Conclusions: Our results show a high rate of inappropriate use of cast immobilizations for ankle distortions. From an economic point of view and for the same clinical endpoint (being full resumption of the occupational activities), simple conventional treatment, consisting of rest, ice, compression and elevation at diagnosis with allowance of early weight bearing in the further clinical course, leads to the quickest full resumption of activities in combination with the lowest medical costs, if compared with any other kind of treatment. (shrink)

Using an ethical approach to the study of employability, we question the mainstream approach to career self-direction. We focus on a specific category of employees that has been neglected in past research, namely vulnerable workers who have been unemployed for several years and who have faced multiple psychosocial problems. Building on the Ability-Motivation-Opportunity model, we examine how establishing clear expectations, developmental inducements, and social organizational goals can foster employability competences of vulnerable workers. Our study took place in the particularly relevant (...) context of social enterprises, which have a primary goal to enhance the employability competences of vulnerable workers. Multilevel analysis of data from 38 CEOs of social enterprises, 121 leaders and 594 workers, demonstrated that establishing clear expectations and developmental inducements enable vulnerable workers to anticipate and optimize their employability competences. Furthermore, a positive association was found between establishing clear expectations and the balance dimension of employability, yet only in social enterprises that prioritize social organizational goals, suggesting the need to recognize the extent organizational goals shape opportunities for vulnerable workers. Establishing clear expectations and developmental inducements can therefore enhance vulnerable workers’ employability competences in supportive contexts; however, there may be detrimental side effects to drifting away from social organizational goals. (shrink)

Notwithstanding fears of overly permissive approaches and related pleas to refuse euthanasia for psychological suffering, some Belgian hospitals have declared that such requests could be admissible. However, some of these hospitals have decided that such requests have to be managed and carried out outside their walls. Ghent University Hospital has developed a written policy regarding requests for euthanasia for psychological suffering coming from patients from outside the hospital. The protocol stipulates several due care criteria that go beyond the requirements of (...) the Belgian Euthanasia Law. For instance, the legally required first and second consulted physicians should all be psychiatrists and be affiliated with a psychiatry department of a Flemish university hospital. Moreover, euthanasia for psychological suffering can only be performed if the advices of these consulted physicians are positive. Importantly, preliminary reflection by the multidisciplinary Hospital Ethics Committee was introduced to discuss every request for euthanasia for psychological suffering coming from outside the hospital. In this way, the protocol supports psychiatrists faced with the complexities of assessing such requests, improves the quality of euthanasia practice by ensuring transparency and uniformity, and offers patients specialised support and guidance during their euthanasia procedure. Nevertheless, some concerns still remain. (shrink)

Transformational leadership is a popular and well-researched leadership style. Although much is understood about its positive consequences, less research has focused on antecedents of transformational leadership. In this research we draw upon self-determination theory and incorporate a self-regulatory approach to investigate if and how leader mindfulness influences transformational leadership. The analyses show that autonomy, competence and relatedness need satisfaction mediate between mindfulness and transformational leadership, indicating that mindfulness is associated with psychological need satisfaction. Furthermore, the data show that neuroticism moderates (...) the relationship between mindfulness and relatedness need satisfaction. Generally speaking, the association between mindfulness and relatedness need satisfaction is positive. When neuroticism is also high, mindfulness has the largest impact. Or conversely, when emotional stability is high, mindfulness has the smallest association with relatedness need satisfaction. This is in line with evidence suggesting that mindfulness may primarily exert its influence through emotional self-regulation. Furthermore, the moderated mediation model for relatedness satisfaction is significant, indicating that neuroticism is a boundary condition for the indirect effect of mindfulness on transformational leadership through relatedness need satisfaction. (shrink)

In a context where the amount of red tape in healthcare organizations continues to rise, head nurses’ job satisfaction is constantly under pressure. By building on the Job Demands-Resources model, we developed a theoretical model investigating the relationship between red tape and job satisfaction. By investigating the mediating role of discretionary room and the moderating role of autonomous motivation in this relationship, this study does not only aim to provide additional knowledge regarding the underlying mechanisms in this relationship, but also (...) to increase our understanding of how this suffering at work can be mitigated. Our conditional process analyses indicate that red tape undermines head nurses’ job satisfaction and that discretionary room acts as an underlying mechanism in this process. By revealing the mediating role of discretionary room, this study advances our understanding of the risks originating from red tape for leaders. Furthermore, our findings also indicate that autonomous motivation mitigates the negative relation between red tape and discretionary room and between red tape and job satisfaction. As autonomous motivation turns out to be an important protection mechanism against the negative consequences of red tape, organizations should put extra effort into stimulating the autonomous motivation of their leaders. When organizations make sure that their leaders’ job designs and work environments meet the need for autonomy, competence, and relatedness, leaders will become more autonomously motivated, which will buffer the negative impact of red tape. (shrink)

This article addresses the impact of leader psychological need satisfaction on employees. We draw on the self-determination theory and leader-member exchange theory to investigate if and how leader psychological need satisfaction trickles down to employee psychological need satisfaction. Adopting a multi-actor, multilevel design, results from 1036 leader–employee dyads indicate that employee-rated LMX mediates the trickle-down effect of leader psychological need satisfaction. Additional analyses of leader psychological needs show that leader competence is the main psychological need that underlying this relationship. We (...) also found an unexpected negative association between leader autonomy need satisfaction and employee competence need satisfaction. Overall, this study shows the importance of both leaders’ psychological need satisfaction and employee perceptions of the relationship quality for employee psychological need satisfaction. (shrink)

Ce texte a paru pour la première fois dans Parade sauvage, n° 14, Classiques Garnier, 1997. Nous remercions Yves Letournel de nous avoir autorisé à le reproduire ici. Premiere section – Le dégagement des formes anciennes Ipse ego cana legam tenera lanugine mala, castaneasque nuces, mea quas Amaryllis amabat ; addam cerea pruna ; […] et vos, o lauri, carpam, et te, proxima myrte, sic positae quoniam suauis miscetis odores Ta mémoire et tes sens ne seront que - Poétique (...) et Études littéraires – GALERIE – Nouvel article. (shrink)

An evening seminar was held in connection with the Multatuli lecture in Leuven. During that seminar, Michael Sandel was invited to respond to a few questions springing from his lecture and from his book Democracy’s Discontent. What follows is the transcript of that discussion in which questions were formulated by Antoon Vandevelde , Koen Raes , Amaryllis Verhoeven , Ab Bijma , Bart Pattyn , Joseph Selling and Herman De Dijn.