SummaryBackgroundResults of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects.MethodsFOCUS was a pragmatic, multicentre, parallel group, double-blind, randomised, placebo-controlled trial done at 103 hospitals in the UK. Patients were eligible if they were aged 18 years or older, had a clinical stroke diagnosis, were enrolled and randomly assigned between 2 days and 15 days after onset, and had focal neurological deficits. Patients were randomly allocated fluoxetine 20 mg or matching placebo orally once daily for 6 months via a web-based system by use of a minimisation algorithm. The primary outcome was functional status, measured with the modified Rankin Scale (mRS), at 6 months. Patients, carers, health-care staff, and the trial team were masked to treatment allocation. Functional status was assessed at 6 months and 12 months after randomisation. Patients were analysed according to their treatment allocation. This trial is registered with the ISRCTN registry, number ISRCTN83290762.FindingsBetween Sept 10, 2012, and March 31, 2017, 3127 patients were recruited. 1564 patients were allocated fluoxetine and 1563 allocated placebo. mRS data at 6 months were available for 1553 (99·3%) patients in each treatment group. The distribution across mRS categories at 6 months was similar in the fluoxetine and placebo groups (common odds ratio adjusted for minimisation variables 0·951 [95% CI 0·839–1·079]; p=0·439). Patients allocated fluoxetine were less likely than those allocated placebo to develop new depression by 6 months (210 [13·43%] patients vs 269 [17·21%]; difference 3·78% [95% CI 1·26–6·30]; p=0·0033), but they had more bone fractures (45 [2·88%] vs 23 [1·47%]; difference 1·41% [95% CI 0·38–2·43]; p=0·0070). There were no significant differences in any other event at 6 or 12 months.InterpretationFluoxetine 20 mg given daily for 6 months after acute stroke does not seem to improve functional outcomes. Although the treatment reduced the occurrence of depression, it increased the frequency of bone fractures. These results do not support the routine use of fluoxetine either for the prevention of post-stroke depression or to promote recovery of function.FundingUK Stroke Association and NIHR Health Technology Assessment Programme.

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The extant literature has focused on individuals’ knowledge-sharing behavior and its driving factors, which stimulate the knowledge transmission and exchange in organizations. However, little research has focused on factors that inhibit knowledge sharing and encourage individuals to hide their knowledge. Therefore, based on social exchange and displaced aggression theories, the study proposed and checked a model that examined the effect of abusive supervision on knowledge hiding (KH) via a psychological contract breach (PCB). The Psychological ownership was regarded as a boundary condition on abusive supervision and KH relationship. Using a time-lagged method, we recruited 344 full-time employees enrolled in an executive development program in a large university in China. The findings show that PCB mediates the association between abusive supervision and KH. Similarly, psychological ownership moderates the association between abusive supervision and KH. Employees with high psychological ownership minimized the effect of abusive supervision on KH. Based on study findings, contributions to theory and practice, limitations, and future directions are discussed.

The COVID-19 crisis has drastically affected organizations worldwide, thereby influencing the employees' psychological wellbeing. Since it is a new pandemic, research is sparse in the domain of employees' psychological wellbeing in relation to the phenomenon. Drawing on social support and job demand-resource perspectives, this research adds to the factors affecting employees' wellbeing due to the coronavirus outbreak. Specifically, this study is an investigation of co-workers' instrumental support in predicting employees' emotional exhaustion via employees' perceived uncertainties experienced due to the COVID-19 pandemic. Further, we tested for the contextual specificity of family support on uncertainties and its link with employees' emotional exhaustion. With data drawn from two universities (n = 275), the findings reveal a negative association between co-worker task support and an employee's emotional exhaustion, and an employee's perceived uncertainties mediate this relationship. Moreover, the moderating analysis exhibits that family support mitigates the negative effect of uncertainty perception on emotional exhaustion. Our study reveals that coworker and family support are extremely important during the COVID-19 pandemic. These findings are equally valuable for organizations and society to mitigate the detrimental effects of the COVID-19 pandemic on employees' wellbeing.