Given turbulent economic times, the concept of employee resilience is receiving increasing attention in many organisations. This paper brings the discussion of employee resilience into the field of human resource management (HRM). We explore the foundations of resilience in theories of positive psychology and the conservation of resources (COR); we discuss its relevance for HRM and develop a set of testable hypotheses to guide future research. The first key finding of this paper is that the concept of resilience can be developed from strong theoretical foundations. Second, a coherent set of resilience‐enhancing HR practices have the potential to contribute to employees’ psychological capital, attitudes and behaviour, and to organisational performance not only in turbulent circumstances but also during periods of relative calm. Given the theoretical framing, formal resilience training should be viewed as a single component of a broader, coherent set of resilience‐enhancing HR practices.
Review of the current literature demonstrates that a combined medical and conservative surgical approach is beneficial for most women with endometriosis associated pelvic pain.
Objective
To determine whether goserelin (ZoladexTM; AstraZeneca, London, UK), plus surgery offers advantages over surgery alone in the management of ovarian endometriomas.
Design
Prospective, multicentre, randomized, open‐label, parallel‐group study.
Interventions
Following preoperative aspiration of endometriomas, they were sized by ultrasound, a diagnosis of endometriosis confirmed by laparoscopy and its severity assessed. Patients were stratified according to endometrioma size and randomly allocated to one of two groups: group 1 (G1; n = 21) received a monthly (every 28 days) subcutaneous injection of goserelin 3.6 mg for 3 months (12 weeks); group 2 (G2; n = 27) received no treatment. At 3 months, the size of endometriomas was reassessed in both groups before definitive excision. Both groups were reassessed at 6 months postsurgery.
Main outcome measures
Change in size of the largest endometrioma from entry to just prior to excision.
Results
The mean change in endometrioma size was −2.29 cm in G1 and −1.29 cm in G2. The resulting (adjusted) mean difference of −1.25 cm was statistically significant in favour of G1 (P = 0.036, 95% CI −2.42 to −0.08 cm). Very difficult surgery was reported in four (22%) patients in G1 and 10 (46%) patients in G2. Mean duration of surgery was 74.2 min in G1 and 86.4 min in G2. There was a trend towards a greater reduction in mean Additive Diameter of Implants (ADI) score at 6 months postsurgery in G1 compared with G2 (−65.9 vs. −56.6). Both groups were comparable in terms of the number of complete excisions of their endometrial cysts at surgery, blood loss at surgery, Revised American Fertility Society (R‐AFS) scores and pelvic symptoms. Goserelin was well tolerated.
Conclusions
Laparoscopic aspiration of endometriomas followed by a monthly goserelin 3.6 mg depot for 3 months compared with laparoscopic aspiration alone results in significantly smaller endometriomas at 3 months and a trend towards a greater reduction in ADI score.
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