Professional Repercussions Research Articles

Are we committed to commitment?

IntroductionStudents face difficult decisions when considering multiple opportunities for employment or continued training. When this happens, students may consider breaking a previous commitment to accept a more appealing offer. Societal trends toward decommitment may also influence students' perceptions of the importance of commitment. PerspectiveStudents must consider potentially serious professional repercussions that may result from dishonoring commitment before making such a decision. ImplicationsWe challenge pharmacy faculty to reinforce the professional obligation of honoring commitment when guiding students in career decision-making. We emphasize the importance of helping students develop a specific plan to work toward career goals, entertain only those opportunities that help achieve these goals, and carefully weigh the potential impact of dishonoring commitment on their professional reputation.

The Holistic MAP to Athletic Wellness: A Narrative Review

You can’t use an old map to explore a new world. —Albert Einstein We are at a fork in the evolutionary road to athletic wellness. While elite athletes are achieving unsurpassed magnificence in strength, endurance, power, and skill, much of our population is experiencing a devolution from poor lifestyle choices that negatively influence both human and planetary health. The alarming descent to a lesser state of collective health puts most of our sedentary population at greater risk of injury, disease, dysfunction, and chronic pain. The father of sports medicine, Herodicus, was the first known physician to recommend exercise for the treatment of disease, recognizing its powerful influence on quality of life and health span. Athletic participation is linked with improved physical and mental health, as well as reduced obesity, disability, and disease. However, sports may also result in physical, psychological, social, athletic, professional, and financial repercussions.1 The international scientific community has rallied with tremendous research over the past decades to promote sustainable athletic participation and healthy active living. While tremendous efforts have been launched to engage in this challenging endeavor, a significant problem remains due to the multifactorial nature of athletic injuries. The full potential for body-mind-spirit resilience and wellness is achieved through the balance of all interdependent components, considering all possible biological, psychological, social, and spiritual factors influencing each athlete to establish an individualized, holistic mindset, agility, and personalization (MAP) approach toward injury-free sports and active living.

SP8.13 - Exploring General Surgeons' Experiences of Adverse Events Perceptions of Support: A Scoping Review and Qualitative Study of General Surgical Trainees

Abstract Aims This study aimed to deepen understanding of the psychosocial impacts of adverse events on general surgical trainees and evaluate the experiences of current support mechanisms. Methods The study was conducted in two parts: a scoping review and a qualitative focus group study. The scoping review was conducted in accordance with the PRISMA-ScR guidelines and JBI methodology. These themes were taken forward for extended discussion as part of a focus group study of general surgical trainees (n = 10; split in two discrete groups of five participants). Reflexive thematic analysis using anonymised transcripts and contemporary field notes were used to analyse the data. Results The scoping review identified six themes related to the impact of adverse events on surgeons' well-being and professional performance. These were clarified and elaborated on through qualitative analysis of focus group data, developing three key themes with associated subthemes: (1) Support structures and external factors influencing responses to adverse events, (2) impact on clinical practice and professional development and (3) methods of learning from adverse events. Surgical trainees experience significant emotional and professional repercussions in the aftermath of adverse events, often exacerbated by insufficient formal support and a prevalent blame culture within hospital environments. Conclusions Substantial deficiencies exist in the support structures available to surgical trainees dealing with adverse events. It is evident that the existing systems fail to adequately address the complex needs of trainees, leading to significant emotional distress and professional insecurity. System changes are necessary for surgical trainees, including the establishment of mentorship and peer support networks.

Academic freedom and the unknown: credibility, criticism, and inquiry among the professoriate

In the U.S., military and intelligence personnel, the National Aeronautics and Space Administration (NASA), scholars, professional organizations, legislators, journalists, and others are requesting study of UFOs, recently renamed Unidentified Aerial/Anomalous Phenomena (UAP) by the U.S. government. Yet disinformation, misidentifications, hoaxes, and entertainment cloud the subject. Combined, these factors pertain to wider debates about the parameters of academic freedom. Here, we asked faculty across 14 disciplines at 144 research universities (N = 1460) to register insights about UAP in the academy via confidential survey. To the authors’ knowledge, this is the first national study to examine scholars’ evaluations of academic credibility and possible social or professional repercussions—including concerns for tenure, promotion, and academic freedom—in relation to UAP. Results suggest that faculty concern that conducting UAP-related research would jeopardize their tenure or promotion might exceed colleagues’ actual negativity toward such research on tenure or promotional votes. Only 7.4% of faculty responded that “Yes” they would vote negatively (“No” = 61.92%, “Maybe” = 27.95%), though 52.67% reported some degree of concern for tenure or promotion. Faculty more frequently reported some degree of concern for social rather than professional repercussions. Concern for ridicule totaled 69.04%. Among all faculty, 66.24% reported that their discipline was capable to some degree of evaluating the evidence or significance of UAP. The disciplines of physics (95.82%), philosophy (88.73%), anthropology (87.09%), and engineering (83.15%) most frequently reported capability. Those who most frequently responded “Not at All” capable belonged to economics (59.7%), literature/English (54.46%), nursing (53.33%), and art and design (51.52%). Notably, although physics faculty most frequently responded that their discipline was capable to some degree of evaluation, nearly three in four reported some degree of concern about ridicule. From 250 open-ended responses, we generated 14 themes pertaining to research or teaching. To promote transparency, highlight a range of perspectives, and facilitate debate, for each theme we included at least 3 example quotes. In the context of ongoing developments, we discuss results, which underscore the complexity of beleaguered subjects and render conversations about academic freedom and UAP timely, relevant, and necessary.

The Hidden Costs of Psoriasis: A Population-Based Study Evaluating How Psoriasis Severity Impacts Work Absenteeism.

Psoriasis patients experience physical and emotional burdens, which may lead to work-related productivity loss. This loss carries professional and financial repercussions. It is unknown whether the extent of psoriasis affects work absenteeism. This study aims to compare work absenteeism between employed adults with mild versus moderate-to-severe psoriasis. A national, cross-sectional study using the 2009 to 2019 Medical Expenditure Panel Survey evaluated 5,209,956 (weighted) adults aged ≥ 22 years. Work absenteeism was compared between adults with mild (4,521,687 weighted) and moderate-to-severe psoriasis (688,269 weighted). Work absenteeism, as measured by the average number of episodes per year that someone was absent from work for at least a half day, was significantly higher in patients with moderate-to-severe psoriasis than in patients with mild disease (4.4 episodes vs 2.8 episodes, P=0.002). Multivariable logistic regression models showed moderate-to-severe patients were 2.68 times more likely (95% CI:1.72-4.21; P<0.001) to take a half-day or more off from work than those with mild disease after adjusting for age, sex, race, ethnicity, poverty, cognitive limitations, insurance, education, and comorbidities. Disease severity directly impacts work absenteeism in psoriasis patients. Early diagnosis and treatment with appropriate therapies are needed to reduce disease severity and limit economic loss and professional ramifications associated with psoriasis. J Drugs Dermatol. 2024;23(8):640-644.  doi:10.36849/JDD.7550.

Conscience and Compromise: The Struggle of Moral Codes in Business

Abstract This paper investigates the ethical dilemmas faced by consultants when balancing personal morals with professional obligations, using a real-life case study involving a consultant overhearing illegal price-fixing activities. The case highlights the consultant’s internal conflict and the decision to remain silent due to fear of professional repercussions and power dynamics. The analysis discusses violations of the Dutch OOA code of conduct, particularly concerning integrity and professional independence, and explores the ethical frameworks of moral disengagement, consequentialism, and virtue ethics. The paper emphasizes the complexity of moral integrity in consulting and the potential consequences of both action and inaction in ethically challenging situations.

Leveraging Artificial Intelligence to Address Cross-Cultural Workplace Bullying Among International Students in Australia

Workplace bullying is a pervasive issue with significant psychological, emotional, and professional repercussions for individuals, particularly in culturally diverse environments. This study explores the potential of artificial intelligence (AI) to address cross-cultural workplace bullying experienced by international students in Australia. By leveraging AI technologies such as natural language processing (NLP), sentiment analysis, and machine learning, organizations can enhance the identification, prevention, and intervention of bullying behaviors. The literature review provides a comprehensive overview of workplace bullying, emphasizing the additional complexities introduced by cultural diversity. Case studies and empirical analyses demonstrate the practical application and efficacy of AI-driven strategies, highlighting significant reductions in bullying incidents, improvements in employee well-being, and enhanced cultural awareness. The study underscores the importance of ethical considerations, algorithm transparency, and continuous training in successfully implementing AI systems. The findings offer valuable insights for employers, policymakers, and educators, contributing to the broader discourse on workplace inclusivity and safety.

Impact of post-Dobbs abortion restrictions on maternal-fetal medicine physicians in the Southeast: a qualitative study

BackgroundThe US Supreme Court overturned federal abortion protections in Dobbs v. Jackson Women's Health Organization. Many states in the Southeastern US responded with restrictive policies that limit and criminalize abortion care. ObjectiveTo characterize the impacts of abortion restrictions on maternal fetal medicine physicians (MFMs) in the Southeastern US post Dobbs. Study DesignWe conducted qualitative, semi-structured interviews with 35 MFMs in 10 Southeastern states between February and June 2023. Our recruitment strategy relied on convenience and snowball sampling. Audio-recorded interviews were analyzed using Dedoose software and a descriptive qualitative approach that incorporated deductive and inductive approaches. ResultsEmergent themes were identified, and a conceptual framework was developed based on overarching themes. We found that abortion laws and external constraints following Dobbs resulted in ethical, professional, and legal challenges for MFMs that led to changes in clinical practice and deviations from patient-centered care. These forced changes resulted in negative impacts on MFMs such as increased fear, hypervigilance, and increased workload for MFMs. The changes also prompted concerns about health risks and negative emotional impacts for patients. Supportive colleagues, hospital systems, and policies were associated with decreased stress, emotional distress, and disruption of healthcare delivery. ConclusionsAbortion restrictions in the Southeastern US limit the ability of MFMs to provide or facilitate abortions in the setting of fetal anomalies and maternal health risk. MFMs perceived these restrictions to have negative professional and emotional repercussions for themselves, as well as negative impacts on patients. Supportive colleagues and clear guidance from hospital systems and departments on how to interpret laws were protective. Our findings have implications for the MFM workforce and patient care in the region.

EXPRESS: No Comments (from You): Understanding the Interpersonal and Professional Consequences of Disabling Social Media Comments

Presumably in an effort to reduce cyberbullying and promote mental health, online influencers often limit viewers’ ability to post comments. In this research, we find that influencers incur significant interpersonal and professional repercussions for doing so. Across a Twitter dataset and six experiments utilizing both consequential and hypothetical dependent measures, we find that consumers form more negative impressions of and are less persuaded by influencers who disable social media comments. These outcomes are driven by the perception that the influencer is less receptive to consumer voice (e.g., consumers’ thoughts, opinions, and suggestions) and, thus, less sincere. However, we find that this effect is mitigated in situations where consumers feel that it is reasonable for influencers to prioritize self-protection.

Qualitative study investigating the professional and personal effects of patient suicide on general practitioners in Northern Ireland

ObjectiveThere is a dearth in suicide literature addressing the impact on general practitioners (GPs) of losing a patient. We aimed to examine the personal and professional impact as well as...

The prevalence of seasickness in a population of French civilian sailors.

Motion sickness, is the onset of a series of clinical signs when travelling in a means of locomotion. Boats are the most common source of kinetosis, causing seasickness. Although this condition is often benign, it can severely affect the quality of life of seafarers, as well as the quality of their work. The aim of this study is to focus on the point prevalence and characteristics of seasickness in a population of French civilian seafarers from all shipping sectors. During two months in 2023, we conducted a cross-sectional study based on a questionnaire containing 28 questions. One hundred nine men and 10 women completed the questionnaire. Of these, 34% said they were seasick. The main symptoms described by the sailors were nausea and cold sweats in 87.5% and 50% of cases, respectively. The prevalence of naupathy appears to be higher in women (60% compared with 31% in men). Women also seem to be less accustomed to the marine environment than men, with 71% of men and only 33% of women indicating that they get accustomed to life at sea. However, the symptoms of seasickness seem to disappear more slowly in men than in women. In terms of treatment, men (38%) were more likely to take medication than women (17%). Our study shows a greater susceptibility to seasickness among women. This interpretation should be treated with caution given the small number of women who took part in the study. The relatively low point prevalence of seasickness (34%) could be due to under-reporting. Although ways of thinking are changing, seasickness is still a taboo subject for many sailors. Yet seasickness has major professional and personal repercussions. So it's important to raise the subject and discuss strategies for improving well-being at work.

Suicide Among Healthcare Workers: Risk Factors, Prevention, and Challenges

Mental health disorders, contributing considerably to the global disease burden, have seen a marked increase due to urbanization, economic challenges, and the COVID-19 pandemic. These disorders, encompassing a spectrum from anxiety to schizophrenia, significantly impact individuals' cognitive, emotional, and functional capacities, while also straining societal resources through reduced workforce productivity and escalated healthcare costs. There are multiple mental health struggles of healthcare workers which can be characterized by long hours, highpressure situations, and exposure to trauma. These occupational stressors, intensified during the COVID-19 pandemic, have heightened the prevalence of mental health issues such as depression, anxiety, burnout, and posttraumatic stress disorder among healthcare professionals. The stigma surrounding mental health in the healthcare sector, coupled with fears of professional repercussions, often dissuades workers from seeking necessary help. The pandemic has further exacerbated these challenges, leading to worsening mental health conditions. By understanding the complexities of this crisis, the paper seeks to guide policy changes and institutional initiatives that prioritize and protect the mental health of those who are devoted to the care and well-being of others.

“When things aren't going well at home and at work, it is hard”: What can companies do about domestic violence?

Domestic violence has considerable professional repercussions. Abusive partners isolate victims, damage their self-confidence, belittle them, instill doubt, and create an atmosphere of uncertainty and fear. Such mechanisms of domination, control, and isolation could have consequences for the professional lives of the victims, including absenteeism, decreased performance, and errors. These professional consequences can further isolate the victims because organizational actors, often unaware of or not understanding the domestic violence the victims are experiencing, can hold them accountable for poor work outcomes. This paper reports on action research conducted at EDF, a large French electricity company, and sheds light on the role of the employer in supporting victims of domestic violence, particularly by proposing a set of social and human resources practices that could help the victims escape from abusive situations. However, while it is important for organizations to undertake initiatives in addressing the cases of domestic violence, such involvement remains voluntary and depends on the goodwill of employing organizations. That is what some labor unions wish to change by advocating new professional rights for victims of domestic violence at national levels.

Too scared to share? Fear of social sanctions for political expression on social media

Abstract While social media provide opportunities for political expression, many people may be reluctant to share their opinions if they fear personal or professional repercussions for posting political views. Fear of social sanctions (FOSSs) therefore represents a promising approach to investigate why people often avoid expressing political opinions online. Using panel survey data collected during the 2020 U.S. election, this study examines the predictors of FOSSs, as well as its relationship with several forms of online political expression. Results indicate that the ideological diversity of people’s online networks fosters their FOSSs, which in turn is associated with decreases in several types of online political expression. Thus, FOSSs may be an important determinant in individuals’ calculations to express political opinions online and may also hinder lower commitment forms of political engagement.

Aircraft pilot healthcare avoidance due to fear for aeromedical certificate loss and implications for neurology care of the pilot patient (P4-7.004)

<h3>Objective:</h3> The learner will describe: - Healthcare avoidance and three factors that influence pilot healthcare seeking behavior and disclosure - Implications of pilot healthcare avoidance in the care of the pilot patient with a neurological complaint - Methods to mitigate the impact of pilot healthcare avoidance <h3>Background:</h3> Aircraft pilots are required to meet certain medical standards in order to maintain an active flying status. If a pilot discloses a new symptom or condition during routine aeromedical screening, they run the risk of temporality or permanently losing their ability to fly. This can result in occupational, social and professional repercussions to the pilot. For this reason, it has been proposed that pilots face a barrier to seeking medical care that results in delayed presentation to care and healthcare avoidance. Select interventions for neurological diseases are limited by the duration of symptoms and a delay in care can result in poor health outcomes. <h3>Design/Methods:</h3> A cross sectional survey of 3,650 pilots in the United States showed that 56.1% of pilots reported a history of healthcare avoidance due to fear for aeromedical certificate loss. A subanalysis of military pilots, showed that 72% of US active duty military pilots had a history of healthcare avoidance due to fear for loss of flying status. <h3>Results:</h3> Pilots may delay presentation to care and/or participate in healthcare avoidance due to fear for aeromedical certificate loss. Select neurological interventions are limited by duration of symptoms (i.e. thrombolysis, etc). It is imperative for neurologists to be aware this phenomena. To achieve the same outcome, evaluation and intervention may be required more rapidly compared to non-pilot patients. This presentation will review select mitigation strategies to address pilot healthcare avoidance. <h3>Conclusions:</h3> A proportion of pilots participate in healthcare avoidance. Evaluation and intervention of pilots with a neurological complaints may be required more rapidly compared to non-pilot patients. <b>Disclosure:</b> The institution of Dr. Hoffman has received research support from United States Air Force.

Landscape of pediatric cancer treatment refusal and abandonment in the US: A qualitative study.

To describe United States (US) pediatric oncologists' experiences with treatment refusal or abandonment, exploring types and frequency of decision-making conflicts, and their impact. We conducted exploratory qualitative interviews of pediatric oncologists (n = 30) with experience caring for a pediatric patient who refused or abandoned curative treatment. Interviewees were recruited using convenience and nominated expert sampling, soliciting experiences from diverse geographic locations and institution sizes across the US. We analyzed transcripts using applied thematic analysis to identify and refine meaningful domains. Many oncologists reported multiple experiences with refusal and abandonment. Most anticipated case frequency would increase due to misinformation, particularly on the internet. Interviewees described cases of treatment refusal and abandonment, but also a wider variety of cases than previously described in existing publications, including cases involving: non-adherence; negotiations for different treatments; negotiations for complementary and alternative medicine; delayed treatment initiation; and refusal of a component of recommended therapy. Cases often involved multiple stages or types of conflicts. Recurring patient/family behaviors emerged: clear opposition to treatment from the outset; hesitancy about treatment despite initiating therapy; and psychosocial circumstances becoming an obstacle to treatment completion. Oncologists revealed substantial professional and personal repercussions of these cases. Oncologist interviews highlight a broad range of conflicts, yielding a taxonomy of treatment refusal, non-adherence and abandonment (TRNA) that accounts for the heterogeneity of situations described. Cases' complexity and interrelatedness points to a functional model of TRNA that includes families' behaviors. This preliminary taxonomy and model warrant further research and examination to refine the model and generate strategies to prevent and mitigate TRNA.

Le temps d’une chanson : abord médiatisé de la blessure de guerre en thérapie de groupe

Post-traumatic stress disorders are a major concern for the armed forces. Certain pathognomonic symptoms of psychological trauma are expressed by isolation and avoidance behavior that are antithetical to the principle of group unity and cohesion that is so fundamental in the military. The Robert Picqué military hospital is located in the heart of a region where many operational regiments are stationed. For the past 20 years, the French army has been deployed in different countries at war, on foreign missions or OPEX (Afghanistan, Lybia, Mali) and interior operations or OPINT. The Robert Picqué psychiatric department has adapted its clinical activity to admit and treat the many soldiers who have been injured and has developed a multidisciplinary and integrative approach, which includes group therapy, to treat PTSD. In this context, the combination of two health professionals, one an occupational therapist and the other a psychomotor therapist, has resulted in the creation of an original therapeutic approach using musical and creative mediation in group activities. The benefits of therapeutic synergy help to build a framework for free expression and includes the use of songs and personal creative exercises using a variety of media. From the patients’ artistic creations, their drawings and writing, we can see how this double mediation favors social bonding and makes it possible to understand the personal, family, and professional repercussions of PTSD. Thus, the time of a song provides the patients with a space of relief, of security and the development of a collective elaboration of their suffering.

Retroperitoneoscopic lumbar sympathectomy for plantar hyperhidrosis: surgical technique

Primary hyperhidrosis is a common disease that affects about 5% of the population in which plantar damage exists in 40% of cases responsible for significant social, professional and psychological repercussions. The most effective and sustainable treatment is surgery by thoracic or lumbar sympathectomy depending on the location. Lumbar sympathectomy has long been practiced for the treatment of non-revascularizable obliterating arteriopathy of the lower limbs, and retains a bad reputation, in particular due to sexual dysfunction. However, it is extremely effective for the treatment of plantar hyperhidrosis with 98 to 100% efficiency and thanks to laparoscopy, the operative risks are low and the sexual dysfunction almost nil. Initially described in 1995, since 2002 many teams have improved the technique around the world. The purpose of this article is to describe the technique of retroperitoneoscopic lumbar sympathectomy in 2021 and to discuss its results.

Punishment, Child Abuse, and Mandated Reporting

Child abuse may take multiple forms, such as neglect and physical, emotional, and sexual abuse. In the US, physical abuse is considered a crime and, according to the law, must be reported by those working in numerous professions, among them that of mental health. Failing to report child abuse can have legal and professional repercussions. Corporal punishment (CP), a common disciplinary practice in many cultures and households, may be difficult to distinguish from child abuse. Additionally, perspectives on corporal punishment vary among cultures and may find justifications in religious traditions. Therefore, addressing it in clinical practice is surrounded by ethical and professional challenges.&#x0D; This paper explores the challenges and ideals of addressing CP and physical abuse according to the perspectives of Islam and professional clinical practice, with a particular focus on the American Muslim context. After exploring the Islamic worldview on parenting and CP, the paper will explore ethical dilemmas facing clinicians with regard to reporting child abuse and offer practical recommendations informed by the Islamic tradition and the existing literature on the topic.

599 Bullying and Harassment Awareness Amongst Junior Doctors – an Audit in Morriston Hospital Plastic Surgery Department

Abstract Aim Determine junior doctors’ awareness of bullying and harassment policy and legal requirements of the health board. If lack of knowledge/training, provide required training in the form of staff teaching. Improve workplace culture and staff safety. Method All junior doctors (total of 10) in the plastic surgery department were asked to fill in questionnaire about their experience of bullying and harassment in the workplace. They were asked about their personal experience of bullying and harassment, awareness of the health boards duty, reporting culture and barriers to reporting. The change implemented was staff training and information on where to access health board policies and protocols. After training, a second questionnaire was filled in to see if there was better understanding of the health board policy and the necessary steps in the event of a bullying or harassment incident. Results The health boards policy was easy find on the health board intranet. In the initial questionnaire: 6 out of 10 junior doctors reported experiencing bullying or harassment in the NHS, all 10 reported not being able to define bullying and harassment; and a lack awareness of NHS Wales’ bullying and harassment policy. All 10 reported that they had not reported any bullying and harassment experienced. The junior doctors were asked about barriers to reporting, all 10 identified concerns about repercussions professionally as the main barrier. Conclusions Training on how to identify bullying and harassment, the pathways of escalation and a change in culture over professional repercussions are vital for surgical trainees going forward in the NHS.