Professional Consequences Research Articles

Difficult intravenous access in a paediatric intensive care unit

IntroductionMultiple attempts during peripheral cannulation can have major consequences for patients, relatives, and healthcare professionals, therefore we set out to determine the extent of this problem in a paediatric intensive care unit (PICU). ObjectivesThe main aim was to describe peripheral venous catheter (PVC) and peripherally inserted central catheter (PICC) cannulation in children in the PICU. Secondary objectives were to determine the success rate of the first cannulation attempt, to quantify patients with difficult venous access (DVA), and to explore the association between DVA and sociodemographic, technique and nursing-related characteristics. MethodA cross-sectional descriptive study. Consecutive sampling was used to recruit patients aged 0-18 years admitted to the PICU who required peripheral venous cannulation. An ad hoc questionnaire was used for this purpose, including the presence of DVA as an independent variable. ResultsA total of 163 venous cannulations were reported. A total of 55.8% (91) were performed in patients under 1 year of age. Of these, 38.7% (63) were successful on the first attempt and 36.8% (60) had DVA. When there was DVA, 85% (51) of patients had complications, median time to cannulation by short CVP was 30 minutes [15-53] and 2 or more nurses were required on 80% (48) of occasions. ConclusionsWe found a low success rate at first attempt and a high proportion of DVA. More nurses and time were employed during cannulation and complications increased if the patient had DVA. A statistically significant association was found between DVA and age, weight, poor perfusion, veins that were neither visible nor palpable, DIVA score ≥ 4, history of difficult intravenous access, complications, number of nurses and time spent.

Exploring Pediatric Nurses' Perspectives on Their Work Environment, Work Attitudes, and Experience of Burnout: What Really Matters?

BackgroundPediatric nurses care for some of the most vulnerable patients in our healthcare system and are vulnerable to the impact of the stress of their work on their well-being. Burnout is a potential response to chronic interpersonal stressors and a negative work outcome linked to personal and professional consequences. A thorough understanding of the experience and factors associated with burnout in this population is an important part of developing interventions to mitigate or prevent this workplace outcome. Therefore, our study objectives were to: (1) explain and expand our understanding of pediatric critical care nurses experience of burnout in relation to their work environment and work engagement; (2) provide recommendations for nursing administrators to improve nurses’ work environment, work attitudes, and work outcomes.MethodsA convenience sample of pediatric critical care nurses from a large pediatric quaternary care hospital in Ontario, Canada were invited to participate in this second phase of a sequential explanatory mixed-methods study. Semi-structured interviews were conducted, with and main themes and subthemes distilled through the method of interpretive description.ResultsA total of 18 PICU/CCCU/NICU nurses participated. Derived themes included the experience and identification of burnout, including its prevalence and elusiveness. Their experiences of quality of work-life included themes such as compensation, emotional support at work, respect, their professional identity, and spill over into home life. They discussed components of work engagement, including the work itself, investment into their growth and development, and the meaning of their work. The self-care subthemes included the importance of preparation and recovery, and the use of physical and mental separation as a preservation strategy. The participants’ recommendations for strategies to mitigate burnout were also summarized.ConclusionBurnout is a complex and regularly occurring experience for pediatric critical care nurses. Although the experience may be difficult to self-identify, the impacts on the individuals are profound. Further research and organizational support are needed to test practical and evidence-based interventions to improve the well-being of this population.

Ethical challenges and moral distress among field epidemiologists

BackgroundAs ‘disease detectives’ and directors of public health programs, field epidemiologists play essential roles in protecting public health. Although ethical issues receive considerable attention in medical and research settings, less is known about ethical challenges faced by field epidemiologists in public health programs. Similarly, little is known about moral distress among field epidemiologists, i.e., situations in which they are constrained from acting on what they know to be morally right. Moral distress is strongly associated with empathy fatigue, burnout, reduced job retention, and disengagement. To better understand ethics training needs for field epidemiologists, in February 2019, members of TEPHIConnect, an online and mobile networking platform for Field Epidemiology Training Program (FETP) alumni, were invited to participate in an anonymous survey about ethical challenges and moral distress.ResultsAmong 126 respondents from 54 countries, leading causes of ethical dilemmas included inadequate informed consent (61%), inequitable allocation of resources (49%), and conflicts of interest (43%). These occur primarily in settings of disease outbreaks (60%); research (55%); and public health programs at the state, province, or national level (45%) or community level (43%). Work-related moral distress was reported by 91% of respondents, including 26% who experience it “frequently” or “almost always.” Field epidemiologists working in low- and low-middle income countries were more likely to report moral distress “frequently” or “almost always” than those in higher-income countries (33.0% vs 9.1%, P = 0.006). The most common perceived contributors to moral distress included excessive stress and work demands (30%) and inadequate support from leaders (25%).ConclusionsField epidemiologists face significant work-related ethical challenges, which are endemic to public health and political systems. A substantial proportion of field epidemiologists also experience some degree of moral distress, often in association with these challenges. These findings indicate an unmet need among field epidemiologists for support in navigating ethical challenges, as well as for resources to address the human and professional consequences of moral distress.

Burnout Syndrome among Doctors in Greek Oncology Departments.

Objective: Economic crisis and austerity has dramatic consequences for health care professionals’ mental health. This study aimed to investigate the prevalence of burnout syndrome among doctors working in public or private oncology departments in Greece and its association with factors determined by economic crisis. Method : Medical or radiation oncologists who are members of the National Oncology Societies and practicing oncology at least for one year were enrolled in this study. An On-Line questionnaire consisting of the Maslach Burnout Inventory and an informative questionnaire was utilized. Results: Eighty-six On-Line questionnaires waere analyzed. Radiation oncologists had significantly higher Depersonalization (DP), whereas medical oncologists had significantly higher Emotional Exhaustion (EE) scores. Registrars had higher scores compared to consultants in all subscales of the burnout syndrome. Factors such as ‘‘hospitals are not safe due to the lack or reductions in medical supplies and personnel shortage’’ and ‘‘receiving less than 50% of annual leave’’ were associated with significantly higher levels of EE. Factors such as ‘‘not afraid of moving abroad’’ and ‘‘receiving 100% of annual leave’’ were associated with significantly higher levels of low Personal Accomplishments (PA). The principal component analysis yielded three principal components: ‘future insecurity’, ‘feeling secure while working’ and ‘working conditions associated with burnout syndrome. Conclusion: Several factors associated with austerity resulting from economic crisis significantly influenced prevalence of burnout syndrome among oncologists in Greece. Further studies need to be conducted to mobilize policy makers to develop and implement policies to improve oncologists' mental health.

Does Academic Freedom Protect Antisemitism?—Part II: Social Media, Antizionism, and the End of Academic Freedom

Abstract The rapid rise in the use of social media and in the dissemination of social media posts during the new millennium has blurred the line between professional publications and communications with the general public. The destructive effects of all forms of online hate speech, including antisemitism, have meanwhile become increasingly apparent. Yet the American Association of University Professors reacted in 2015 by declaring that all faculty statements on social media, including those within a faculty member’s areas of teaching and research, are protected from university evaluation by academic freedom. This reverses a long-standing principle that all statements in a faculty member’s areas of professional responsibility are part of his or her professional profile and subject to professional consequences and potential sanctions. Instead, racist or antisemitic social media posts are now to be deemed immune from consequences for job applicants and candidates for tenure. This development has the potential to undermine public confidence in academic freedom and in higher education’s overall ability to exercise professional judgment. A 2021 proposal went still further, arguing that a faculty member should be able to declare a specific body of work officially off limits, protected from any formal review.

Persuasive Technologies and Social Interactions in Professional Environments: Embedded Qualitative Case Study.

BackgroundAlthough previous studies have highlighted the impact of interactions on the web in the context of patient–health care professional (HCP) dyads, this paper extends that context to a triad that includes the role of employers and associated settings with social groups.ObjectiveThis study aims to evaluate how the interactions between individuals and the social use of the platform affect individuals’ use of persuasive technology and, in turn, their work environment actions and responses, by implementing a persuasive technology health and wellness platform in a work environment.MethodsFor 8 months, we deployed a persuasive technology platform with different combinations of health-related features and content in 1 embedded case design with 8 fire stations for a small Canadian city (total number of participant firefighters, n=141) assigned to 1 of 2 treatments—interactive or static webpages. We used text-based content analysis techniques for outcome measures, drawn from a total of 29 participant exit interviews. In addition, medical assessments were conducted at baseline, midpoint, and end point by 7 HCPs and 1 researcher (BM), who also served as the data steward and managed the study.ResultsOur results reveal that group, social, and work influences introduce new elements to the use of persuasive technology, which interact to foster higher levels of individual success. The platform in our study served as part of a larger social system, providing information that facilitated new behaviors at work and home. The 8-month group programs centered on exercise, nutrition, and smoking cessation. Groups of participants coached by certified professionals showed significant increases in sodium awareness, levels of actual exercise, and consistency of activities. As a result of the study, of 141 people, 15 (10.6%) were notified of serious medical health issues and 29 (20.6%) underwent blood work assessments and a privacy shield (protected by federal law) was enacted to protect employees from losing their employment based on any health concerns disclosed.ConclusionsThe persuasive technology platform, in combination with self-management and professional management and social interactions, significantly altered work management behaviors. Interactions among individual outcomes, group influences, and social situations strongly influenced individuals’ behaviors in their work and home environments. Three things further improved the positive results that we observed: privacy shields (which allowed employees to reveal health concerns without fear of professional consequences), individual private activities aligned with group activities, and integration between HCP work with localized, organizational work roles.

Weight discrimination: implications to the workplace

PurposeGiven the prevalence of obesity in society at large and ensuing weight discrimination in the workplace, the purpose of this paper is to bring to light the social stigma attached to obesity, stimulate the discussion around enacting better legislation to alleviate weight-based discrimination in the workplace and highlight the role of human resource (HR) departments in preventing such discriminatory actions.Design/methodology/approachThis paper reviews current perceptions, trends, laws and consequences related to obesity and weight discrimination and discusses the implications for organizations and HR professionals.FindingsWeight discrimination is a real problem in society as a whole and workplaces in particular. HR professionals have a key role to play in removing weight discrimination and creating a more inclusive and equitable workplace.Originality/valueAlthough weight discrimination has significant professional and personal consequences, there is a lack of explicit laws and policies that provide strong protection to impacted individuals. This paper brings the issue to light and discusses the role of HR in eliminating such bias and discriminatory practices in the workplace.

Social Work Responses to Domestic Violence During the COVID-19 Pandemic: Experiences and Perspectives of Professionals at Women’s Shelters in Sweden

This study explores how social work professionals at women’s shelters in Sweden experience, understand, and are responding to domestic violence under the impact of the COVID-19 pandemic. A qualitative longitudinal research design was employed, and multiple semi-structured interviews were conducted with 14 professionals at women’s shelters over a period of one year. The results are presented in three overall themes; (a) professional challenges due to increased needs, (b) professionals’ adjustments to new circumstances, and (c) professionals’ attributions regarding client barriers to help seeking. The results show diverse and changing experiences among the professionals as the pandemic progressed. Clients and professionals have shared the same collective trauma associated with the pandemic, which has affected the professionals’ understanding of and response to domestic violence. The professionals understand both clients and themselves as being more vulnerable and susceptible to risk under these new circumstances. Social work adjustments focused on maintaining contact, reducing risk and prioritizing safety, which had both positive and negative consequences for both clients and professionals. The study concludes that the professionals coped with the uncertainty they experienced during the pandemic by relying on both their previous knowledge and work experience of domestic violence and their experience of sharing trauma with clients.

Vocal Health and Vocal Health Knowledge Among Occupational Voice Users in the Province of Quebec

Voice disorders are frequent among occupational voice users such as teachers. Although these disorders can have serious personal and professional consequences, they are not often recognized as occupational diseases and little attention is paid to their prevention. This study aimed to provide a portrait of the self-reported vocal health and vocal health knowledge of occupational voice users in Quebec, Canada, and to identify risk factors associated with voice disorder symptoms. We conducted an online survey targeting occupational voice users in the province of Quebec, Canada, with a focus on those involved in teaching or training. The final sample, after excluding incomplete surveys, included 808 respondents (665 women, M = 41.5 ± 10.4 years old). The survey responses were analyzed using descriptive and inferential statistics. Results indicated that 9.8% of the respondents had a history of a diagnosed voice disorder and 68.8% of the respondents experienced at least one voice symptom on a regular basis. Ordinal logistic regressions revealed that several personal and environmental factors are associated with an increased risk of developing voice disorders symptoms: being a woman, suffering from a breathing disorder, allergies, acid reflux and/or hearing impairment, having less work experience, working with elementary school children and/or with continuous or speech noise in the background. Most of the respondents (94.6%) had never received information regarding voice disorders during their academic training and less than half of them (47.7%) knew which professionals can treat voice disorders. These findings highlight the need for formal vocal health education among both occupational voice users and their employers to improve prevention and treatment for voice disorders in an at-risk population.

Civil juror compensation and judgments of police use of force at the intersection of race and mental illness.

More than 53 million people come in contact with police each year, with people of color and those with mental illness (MI) being subjected to increased rates of contact. Sometimes police and civilian interactions have fatal outcomes, and these populations are disproportionately affected. As a result, families of these victims sometimes seek monetary compensation through civil litigation. The current study sought to understand how victim race and mental illness might impact civil juror decision-making in deadly police use of force cases. Participants (N=177) were exposed to trial evidence and were assessed on a number of dimensions. Results display a strong influence of mock jurors' attitudes toward police legitimacy on compensatory damages, as well as interaction effects between attitudes toward police legitimacy and victim race on punitive damage awards and opinions on what professional consequences the involved police officer should face. Implications and future directions are discussed.

The Personal and Professional Impact of Patients' Complaints on Doctors-A Qualitative Approach.

Background: Complaints regarding medical practice represent a harsh reality of the current world. Patients have the right to receive explanations and compensation when they are injured during the medical act, but the increased potential for exposure to complaints determines personal and professional consequences for the doctors, with significant impact on their health and practice. Thus, the aim of our research was to analyze in depth the impact of complaints on the doctors involved. Materials and methods: The authors conducted a qualitative study, using a semi-structured interview, addressed to doctors who had complaints from patients. The participants in our research were identified using an adapted version of the snowball method. Results: After the analysis of the interviews using the inductive method, nine themes resulted, seven of which are addressed in this paper: injustice, personal impact, professional impact, difficulties, supportive factors, the attitude of the hospital management and the attitude of colleagues. At the personal level, the doctors were overwhelmed by insomnia, nightmares, stress and anxiety, and at the professional level by doubts about medical decisions, fear, anxiety and the tendency to avoid patients with severe diseases. Conclusions: The study revealed that physicians who had complaints from patients are deeply affected by the complaint itself and the associated investigation procedure, even if, to a lesser extent, some of the participants found motivation for a better management of the situation. The study also showed the need for changes in the legal and medical systems in order to create mechanisms to support the doctors during the investigation process.

Positive Consequences of the Hidden Curriculum in Undergraduate Nursing Education: An Integrative Review.

Background:Hidden Curriculum (HC) plays an essential role in nursing education and professionalism. However, its positive consequences have been overlooked. Thus, this study aimed to explore and discuss the positive consequences of HC in nursing undergraduate education.Materials and Methods:A comprehensive literature search was conducted to investigate articles published between January 2010 and December 2020. Furthermore, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used to select articles, and Consolidated criteria for Reporting Qualitative research (COREQ) and Strengthening the Reporting of Observational studies in Epidemiology (STROBE) tools were employed to appraise qualitative and quantitative studies, respectively. The applied search strategy resulted in a final list of 16 articles out of a total of 132 articles. Next, the data were integrated and categorized using the Whittemore and Knafl methodology.Results:Three categories were identified: Individual Consequences; involving increased self-confidence, self-esteem, assertiveness, adaptation, autonomy, and lifelong learning. Social Consequences; involving enhanced socialization, cultural consciousness, and social interactions. Professional Consequences; involving professional socialization, professional identity, professional ethics, link theory and practice, and professional dignity.Conclusions:Altogether, we concluded that the emergence of HC and its positive and remarkable consequences in nursing knowledge helps the personal, social, and professional development in nursing.

Мотивация специалиста силовых структур как основная компонента профессионально-личностной надежности в сложных ситуациях

<p>The article discusses the motivational aspects of professional and personal reliability of a specialist of law enforcement agencies. The peculiarities of the dynamics of his professional motivation in difficult situations are revealed. The ways of maintaining it at the level necessary for the performance of professional tasks are highlighted. The problem of controlling and increasing the motivation of a specialist as a professional is investigated, which makes it possible to effectively provide psychological support for a professionally significant motivational orientation. Theoretical analysis and experimental approbation of the problem solution are presented. The sub-components of the motivational factor in the course of a number of studies are justified: dispositional motivation; situational motivation; stable Self-image in the context of fulfilling professional duty; reflexivity of motives. The features of the resulting motivation dynamics are investigated, it is experimentally established that the dynamics of a specialist’s motivation in various professional situations has its own patterns and is implemented in they are divided into the main four stages. In situations of practical activity, the motivational factor of professional and personal reliability, according to the authors, is constantly present at the background level. The main motivating component for actions to perform professional tasks directly in a situation is the presence of a rationalized professional dispositional motivation; awareness by a specialist of the professional and personal consequences of his actions; the ability to reflect, self-determination, that is, to arbitrarily activate internal situational motivation.</p>

Syndróm vyhorenia u zdravotníckych pracovníkov

Described as a modern disease of epidemic proportions, burnout evolved from a unique association with human service workers. It was first defined in the 1970s as a state of exhaustion due to excessive work demands and has since gained worldwide attention as a problem of psychosocial adjustment. Burnout can occur in any profession, but the syndrome occurs mainly in professions that have as a common feature work with people, or at least contact with people and dependence on their evaluation. It seems that one of the most common groups is health workers, which can have significant negative personal as well as professional consequences for them. But despite these facts, widespread public interest and extensive publications, there remains a debate about what burnout syndrome actually is, what its diagnostic criteria are, its prevalence, and whether it should be considered a distinct psychopathological entity.

Non-reporting of Medication Administration Errors among Nurses in Qatar

Background: Prompt recognition and reporting of Medication Administration Errors (MAE) are paramount in ensuring patient safety in hospitals. The data on under-reporting MAE in Middle East Area is limited.
 Aim: The study intended to estimate the percentage of fear factor and explore the perception of nursing professionals regarding the reason for the occurrence and underreporting of MAE.
 Design: A cross-sectional design was utilized to conduct the current study.
 Place and Duration of Study: The study was conducted in eight hospitals working under Public health sector of Qatar between August and September 2016 
 Methodology: The data were collected with a purposive sample of 487 clinical nurses employed by the public health sector of Qatar who responded to a pre-designed online questionnaire.
 Results: The perceived prevalence of fear factor in non-reporting MAE was 23.45%, 95% confidence interval (C.I).: 16% to 33%. The single factor confirmatory factor analysis (CFA) model explained 65% of the variance in the fear factor of nonreporting of medication administration errors. The highest mean score in the subscale of reasons for non-reporting of MAEs includes fear (mean 0.652±1.671) and administrative responses (mean 0.304±1.466), and reporting processes (mean -0.505±1.669), whereas disagreement over hospital definition (mean -1.158±1.528) of error was the least significant reason for nonreporting of MAE by the clinical nurses.
 Conclusion: The study focuses on quantifying the fear factor and underscores the Nurses' fear about the professional consequences of reporting MAE. The findings in this study not only provide evidence concerning the fear of reporting MAE but also shed light on the contributing factors and reasons for the nonreporting of MAE. Nursing leadership needs to concentrate on modifying existing strategies and policies to more comprehensible approaches to reporting errors.

Exploring the Validity Based on Internal Structure of the Oldenburg Burnout Inventory – Medical Student (OLBI-MS)

Construct The study gathers validity evidence for the use of the Oldenburg Burnout Inventory – Medical Student (OLBI-MS), a 16-item scale used to measure medical student burnout. The 16 items on the OLBI-MS are split to form two subscales, disengagement and exhaustion. Background Medical student burnout has been empirically linked to several detrimental professional and personal consequences. In recognition of the high prevalence of medical student burnout, one recommendation has been to regularly measure burnout using standardized measures that have strong validity evidence for their intended use. The OLBI-MS, a frequently used measure of medical student burnout, was adapted from the Oldenburg Burnout Inventory (OLBI). The OLBI has been studied in many occupational settings and been found to have a two-factor solution in majority of these populations, but there is limited validity evidence available that supports the use of the OLBI-MS subscales in a medical student population. Approach Two years of Association of American Medical College Year 2 Questionnaire data (n = 24,008) were used in the study for a series of exploratory and confirmatory factor analyses. The data from the first year (n = 11,586) was randomly split into a confirmatory and exploratory sample, with the data from the second year (n = 12,422) used as a secondary confirmatory sample. Because the questionnaire is administered to medical students during their second year of undergraduate medical education, we consider this a study as providing validity evidence specifically for the measure’s use with that population. Findings The two-factor structure of the OLBI-MS was not empirically supported in the second year medical-student population. Several of the items had low inter-item correlations and/or moderate correlations with unexpected items. Three modified versions of the OLBI-MS were tested using subsets of the original items. Two of the modified versions were adequate statistical explanations of the relationships in the data. However, it is unclear if these revised scales appropriately measure all aspects of the construct of burnout and additional validity evidence is needed prior to their use. Conclusions The use of the OLBI-MS is not recommended for measuring second-year medical student burnout. It is unclear if the OLBI-MS is appropriate for medical students at all, or if different measures are necessary at different stages in a medical student’s professional development. Additional research is needed to either improve the OLBI-MS or use it as a foundation for a new measure. Supplemental data for this article is available online at at www.tandfonline.com/htlm .

Women's adversities

It is up to the State to promote appropriate measures to “guarantee fundamental rights and freedoms and the respect for the principles of a democratic law State”, in accordance with Article 9 (b) of the Constitution of the Portuguese Republic. Our objectives were to examine how the Portuguese legislator is attentive to the particularities of being a woman in matters such as hygiene, health, motherhood and parental education during the execution of sentences and we wanted to investigate the mechanisms triggered by the State for protection, as a preventive measure, of women as victims of crimes. We made research, in numerical terms, to know the rate of constituted women accused in criminal proceedings, as well as the number of convicted, from a set of recent and of reference official documentary sources, based on the existing statistical resources. We also made an analysis of the pertinent legislative diplomas, among them, the aforementioned Code of the Execution of Penalties and Freedom Deprivation Measures and the General Regulation of Prison Establishments. The fulfilment of a prison sentence implies vast and varied consequences, from personal to familiar, passing through social and professional consequences, among others. We concluded that compared to the male universe, the number of women accused and convicted is clearly lower. On the other hand, it is women who make up the largest share as victims of certain offenses. According to the 2019 Annual Report, authored by APAV, female victims amounted to 8,394.

Exploring academics’ identities in today’s universities: a systematic review

PurposeThe study aims to analyse international studies on the impact that new forms of control and performativity in higher education have on academics’ identity. The aim was threefold, namely, to provide an overview of the main published findings; to establish biases and future lines of research and to offer a starting point to stimulate a debate on the future of universities.Design/methodology/approachThe present study consists of a systematic review aimed at providing an overview of the main professional identities (PIs) described in the literature in the past 10 years. A bibliographic search was conducted on the Web of Science, SCOPUS and Education Resources Information Centre, which yielded a total of 26 articles that were subsequently subjected to thematic analysis.FindingsThe study provides an overview of the types of identities developed by academics as a result of the new forms of control. Among the main findings, this study reveals a clear predominance of PIs characterised by submission to the new neoliberal demands. The professional, social and health consequences associated with these identities are also highlighted. Finally, a proposal is made for future research to better understand how these new PIs are constructed and developed.Research limitations/implicationsBecause of the chosen filters or databases, the study could have omitted possible articles relevant to this review. Therefore, researchers are encouraged to replicate such a study by expanding, for example, the languages used.Originality/valueThis study helps us to obtain a detailed description of the different identities generated as a consequence of the new governance of higher education. Furthermore, possible implications for mitigating this situation are mentioned.

Факторы, взаимосвязанные с ростом потребления алкоголя в первые месяцы пандемии COVID‑19 среди пользователей социальных онлайн‑сетей в России

The significant proportion of the Russian population are active online social media users. Changes in alcohol consumption in this target group during the COVID-19 pandemic remain understudied. The aim of this survey was to investigate changes in alcohol consumption and factors associated with the increase in alcohol use among online social media users in Russia during the first months of the COVID-19 pandemic. An online survey was conducted among 1,518 users of online social networking services popular in Russia from June to September 2020. The survey revealed that 35.4% of men and 25.6% of women started drinking more frequently during the first months of the pandemic; 24.9% of men and 17.7% of women increased their usual consumption (volume) of alcohol on a typical drinking occasion, whereas 28.5% of men and 27.9% of women increased the frequency of heavy episodic drinking. Adjusted binary logistic regression analysis revealed a positive association between the increase in the frequency of alcohol consumption and the following factors: age from 18 to 29 years (OR: 1.710; 95% CI: 1.002–2.917), severe restrictions in everyday private life (OR: 3.127; 95% CI: 1.011–9.675) and severe negative professional or financial consequences due to the spread of SARS-CoV-2 (OR: 2.247; 95% CI: 1.131–4.465). The odds of an increase in the frequency of heavy episodic drinking were more than twice higher (OR: 2.329; 95% CI: 1.001–5.428) among those who had experienced severe negative consequences of the pandemic to their professional and financial situation. Higher typical frequency and usual consumption (volume) of alcohol on a typical drinking occasion and higher typical frequency of heavy episodic drinking before the pandemic were positively significantly associated with the increase in these parameters of alcohol consumption during the first months of the pandemic. In times of large-scale epidemics and public health crises, it is advisable to consider the possibility of implementing screening and brief interventions, including via online social media, to prevent problems associated with alcohol use.

Reflections on, and responses to, managerial adverse reactions to healthcare advocacy by psychiatrists and trainees.

For psychiatrists and trainees, to reflect upon adverse managerial reactions to healthcare advocacy about patient care and safety, drawing upon examples from general healthcare settings, and to share approaches to addressing these reactions. Psychiatrists and trainees engaging in healthcare advocacy may face adverse responses from healthcare management, with personal and professional consequences. Advocates need to consider counterstrategies to negative actions by management that may include workplace incivility, bullying and harassment. Health advocacy is more effective within a network of peers, patients and the broader community, including medico-political professional organisations, such as the Australian Medical Association, Royal Australian and New Zealand College of Psychiatrists, and Unions. These organisations should advocate openness to doctors highlighting healthcare safety and quality, as well as prevention of workplace bullying.