Sexual harassment in the medical profession: Legal and ethical responsibilities

Sexual harassment of women in medicine in the Australian medical profession is a serious problem which presents substantial legal, ethical and cultural questions for the medical profession. Women have enforceable legal rights to gender equality and freedom from sexual harassment in the workplace. Both individual offenders and their employers face significant legal consequences for sexual harassment. Individual medical practitioners and employers need to understand their legal and ethical responsibilities in this context. This article analyses four areas of legal liability in every State and Territory which apply to individual offenders and employers: criminal law, discrimination law, civil law, and contract law. It also analyses ethical duties owed by doctors towards their colleagues under professional regulatory schemes. The analysis shows that individual doctors and their employers have clear legal and ethical obligations to prevent sexual harassment. On legal and ethical grounds, medical employers, professional colleges and associations, and regulators need to improve gender equality and professional culture in medicine. A five-step model for cultural change is proposed.

Integrating LGBTIQ health personnel in the workplace: A literature review

Aim Lesbian, Gay, Bisexual, Transgender (LGBTIQ) issues have attracted attention in the popular media. The purpose of this study was to explore the workplace acceptance and experiences of LGBTIQ health and medical practitioners. Methods A systematic search of academic databases and reference lists from selected papers were the sources of the data. Inclusion criteria were research papers published in English, which focused on workplace acceptance and experiences of LGBTIQ health personnel. Both authors abstracted data from all eligible papers. Results Thirty-three papers were included in this review. Evidence indicated that LGBTIQ health personnel experienced discrimination from their patients, heterosexual colleagues and within the LGBTIQ community. Positive contribution of LGBTIQ health personnel include improved patient care and role models for LGBTIQ peers. Inclusive policy is required for LGBTIQ health personnel workforce retention. Conclusions There has been improvement in the acceptance and experiences of LGBTIQ health personnel in recent times. An inclusive workplace policy of LGBTIQ embraces and celebrates the value of diversity.

The role of time pressure and different psychological safety climate referents in the prediction of nurses’ hand hygiene compliance

In this study of 638 Australian nurses, compliance to hand hygiene (HH), as defined by the “five moments” recommended by the World Health Organisation (2009), was examined. Hypotheses focused on the extent to which time pressure reduces compliance and safety climate (operationalised in relation to HH using colleagues, manager, and hospital as referents) increases compliance. It also was proposed that HH climate would interact with time pressure, such that the negative effects of time pressure would be less marked when HH climate is high. The extent to which the three HH climate variables would interact among each other, either in the form of boosting or compensatory effects, was tested in an exploratory manner. A prospective research design was used in which time pressure and the HH climate variables were assessed at Time 1 and compliance was assessed by self-report two weeks later. Compliance was high but varied significantly across the 5 HH Moments, suggesting that nurses make distinctions between inherent and elective HH and also seemed to engage in some implicit rationing of HH. Time pressure dominated the utility of HH climate to have its positive impact on compliance. The most conducive workplace for compliance was one low in time pressure and high in HH climate. Colleagues were very influential in determining compliance, more so than the manager and hospital. Manager and hospital support for HH enhanced the positive effects of colleagues on compliance. Providing training and enhancing knowledge was important, not just for compliance, but for safety climate.

Encouraging Generosity: The practice & organisation of fundraising across nations

This paper is drawn from data provided by colleagues around the world who have written chapters for a book entitled ‘Palgrave Research Companion to Global Philanthropy’ (eds. P. Wiepking and F. Handy, forthcoming 2014). Whilst the focus of the book is a c omparative global study of charitable giving, it also contains information on the activity involved in prompting charitable gifts in each country or region. This paper synthesizes, analyses and discusses this data in relation to factors such as: how fundra ising is organized in different geographical domains; the most common methods of fundraising found in different countries; and the extent to which the fundraising industry is professionalized around the world. The paper begins by noting the lack of resear ch on fundraisers and fundraising in contrast to the extensive studies undertaken of donors. It argues that the demand - side of charitable transactions is worthy of greater attention, because giving and asking are two sides of the same coin. This paper seek s to help rectify the situation by drawing out issues related to the practice and organization of fundraising across the world and linking it to the patterns of charitable giving that are described in the book.

Matters Arising: Role of HLA genes in familial spondyloarthropathy

Said-Nahal and colleagues report an intriguing finding of an association with HLA-DR4 independent of B27 in families with ankylosing spondylitis (AS),1 a finding highlighted by an accompanying editorial.2 The approach of studying B27 positive and B27 negative haplotypes may prove powerful in identifying further cis or trans encoded genes involved in AS. However, the reported association of DR4 with AS is quite a surprising finding given that no difference was noted in B27-DR4 haplotype frequencies in patients and ethnically matched healthy controls. Many previous studies have not reported any such association,3–9 including a similar preliminary study by the same authors.10 Although these studies were mainly case-control studies, population stratification is highly unlikely to cause a false negative finding if the effect size of the reported association with DR4 is as high as Said-Nahal and colleagues describe...

Letter Reply: Distribution of TNFA haplotypes in healthy Caucasians: Comment on the articles by Newton et al and Zeggini et al

We thank Ploski and colleagues for their interest in our study. The explanation for the difference in our findings is a typographic error in Table 2 of our article, whereby the alleles for marker TNF ⫺1031 were labeled incorrectly...

Genetic studies of osteoporosis: A rethink required

It has been 10 years since the seminal paper by Morrison and colleagues reporting the association of alleles of the vitamin D receptor and bone density [1], a paper which arguably kick-started the study of osteoporosis genetics. Since that report there have been literally thousands of osteoporosis genetic studies published, and large numbers of genes have been reported to be associated with the condition [2]. Although some of these reported associations are undoubtedly true, this snow-storm of papers and abstracts has clouded the field to such a great extent that it is very difficult to be certain of the veracity of most genetic associations reported hereto. The field needs to take stock and reconsider the best way forward, taking into account the biology of skeletal development and technological and statistical advances in human genetics, before more effort and money is wasted on continuing a process in which the primary achievement could be said to be a massive paper mountain. I propose in this review that the primary reasons for the paucity of success in osteoporosis genetics has been: •the absence of a major gene effect on bone mineral density (BMD), the most commonly studied bone phenotype; •failure to consider issues such as genetic heterogeneity, gene–environment interaction, and gene–gene interaction; •small sample sizes and over-optimistic data interpretation; and •incomplete assessment of the genetic variation in candidate genes studied.

Speaking of supervision: A dialogic approach to building higher degree research supervision capacity in the creative arts

In the emergent field of creative practice higher degrees by research, first generation supervisors have developed new models of supervision for an unprecedented form of research that combines creative practice and written thesis. In a national research project, entitled 'Effective supervision of creative practice higher research degrees', we set out to capture and share early supervisors' insights, strategies and approaches to supporting their creative practice PhD students. From the insights we gained during the early interview process, we expanded our research methods in line with a distributed leadership model and developed a dialogic framework. This led us to unanticipated conclusions and unexpected recommendations. In this study, we primarily draw on philosopher and literary theorist Mikhail Bakhtin's dialogics to explain how giving precedence to the voices of supervisors not only facilitated the articulation of dispersed tacit knowledge, but also led to other 20 discoveries. These include the nature of supervisors' resistance to prescribed models, policies and central academic development programmes; the importance of polyvocality and responsive dialogue in enabling continued innovation in the field; the benefits to supervisors of reflecting, discussing and sharing practices with colleagues; and the value of distributed leadership and dialogue to academic development and supervision capacity building in research education.

LGBTIQ experiences in the workforce

The experience of lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) health consumers has, in the last decade, gained attention and is now recognised as one of the social determinants of health. Our recent meta-synthesis on the experiences of LGBTIQ health and medical professionals demonstrated that they are susceptible to higher levels of anxiety and depression partially due to lack of acceptance in their workplace. The paramedic workforce is known to be a high risk occupational group for post-traumatic stress disorder and depression. Theoretically, LGBTIQ paramedics working in a heteronormative culture may experience increased level of discrimination and stress than their heterosexual colleagues. The integration of LGBTIQ into the paramedic workforce is unfeatured in our systematic review. While LGBTIQ health professionals receive legislative protection against discrimination, discrimination still exists in practice through lack of visibility. There is a common misconception that LGBTIQ is a homogenous group with equal needs. Effective and efficient integration of LGBTIQ health professionals could improve workplace satisfaction, workforce retention, and equity of access by marginalised groups.

ASEAN and ADB implementing new approaches to building road safety capacity

Following the Association of Southeast Asian Nations (ASEAN) senior transport officials meeting in May 2011, the Secretariat requested the Asian Development Bank (ADB) to provide assistance to improve road safety in ASEAN. In response, ADB, funded by the Japan Fund for Poverty Reduction, has begun an innovative approach to capacity building that has already been adapted and replicated in other sub-regions. This paper will discuss the model central to the project. The Road Safety Capacity Building for ASEAN Project commenced in May 2013. Each country has appointed a National Focal Point (NFP) to identify and coordinate information. A team of International Experts were appointed to develop materials and present a comprehensive train the trainer program focused on five key areas. Thirty eight senior Government officers from across ASEAN attended a two week program at ADB headquarters in Manila and will arrange and deliver specific training and associated activities to other colleagues within their country. ADB has appointed a National Consultant to work in partnership with the trainees on a range of activities including development of “pipeline project proposals” for funding consideration investors and donors. As part of the project, a draft ASEAN Regional Road Safety Strategy document has been prepared and consultation will further refine its directions and contents. The project will reach its conclusion in 2015 and a follow up phase three project is being considered.

#auspol: The hashtag as community, event, and material object for engaging with Australian politics

Critical, loud, highly discursive and polarised; the #auspol hashtag represents a space, an event and a network for politically involved individuals to engage in and with Australian politics and speak to, at and about a variety of involved stakeholders. Contributors declare, debate and often berate each other’s opinions about current Australian politics. The hashtag itself is an important material object and engagement event involved within this performance of political participation. As a long-standing institution in the Twittersphere, and one studied by the authors and their colleagues since its early beginnings (Bruns and Burgess, 2011; Bruns and Stieglitz, 2012; 2013), the #auspol hashtag provides a potent case study through which to explore the discursive and affective dimensions of a hashtag public. This chapter that engages both empirically and theoretically with the use of this particular hashtag on Twitter to provide a qualitatively illustrated case in point for thinking about the long-term use of political hashtags as engagement events.

Workplace acceptance and experiences of LGBTIQ health professionals: A systematic literature review

Background The purpose of this study was to explore the workplace acceptance and experiences of lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) paramedics. Methods A systematic search of academic databases and reference lists from selected papers were the sources of the data. Inclusion criteria were research papers published in English, which focused on workplace acceptance and experiences of LGBTIQ health personnel. Results The initial focus of this systematic review was the workplace acceptance and experiences of LGBTIQ paramedics. However due to no published research specific to the paramedic profession the scope of the review was broadened to include of all LGBTIQ health personnel. Thirty-three papers were included in this review. Evidence indicated that LGBTIQ health professionals experienced discrimination from their patients, heterosexual colleagues and ‘closeted’ LGBTIQ peers. Positive contribution of LGBTIQ health professionals include improved patient care and role models for LGBTIQ peers. Inclusive policy is required for LGBTIQ health professional workforce retention. Conclusions The paramedic workforce is known to be a high risk occupational group for post-traumatic stress disorder and depression. Theoretically, LGBTIQ paramedics working in a heteronormative culture experience increased level of stress. While LGBTIQ health professionals receive legislative protection against discrimination, discrimination still exists in practice through lack of visibility. Effective and efficient integration of LGBTIQ health professionals could improve workplace satisfaction, workforce retention, and equity of access by marginalised groups. An inclusive workplace policy of LGBTIQ embraces and celebrates the value of diversity.

Male nursing students in training: A comparative analysis of hidden advantage and discrimination

Aim The aim of this study was to examine the lived experience of men training to be registered nurses within a regional New Zealand context. Design This study draws upon the key principles of descriptive phenomenology. Sample Five male students enrolled from the 1st and 3rd year of the BN programme. Findings - A Career with Prospects - Gender inequality by superiors; - Developing professional boundaries with female colleagues; - Being unique has its advantages.

Evolution in design of integral leg prosthesis leads to improved outcomes

Developments of surgical attachments for bone-anchored prostheses are slowly but surely winning over the initial disbelief in the orthopedic community. Clearly, this option is becoming accessible to a wide range of individuals with limb loss. Seminal studies have demonstrated that the pioneering procedure relying on screw-type fixation engenders major clinical benefits and acceptable safety. The surgical procedure for press-fit implants, such as the Integral-Leg-Prosthesis (ILP) has been described Dr Aschoff and his team. Some clinical benefits of press-fit implants have been also established. Here, his team is once again taking a leading role by sharing the progression over 15 years of the rate of deep infections for 69 individuals with transfemoral amputation fitted with three successive refined versions of the ILP. By definition, a double-blind randomized clinical trial to test the effect of different fixation’s design is difficult. Alternatively, Juhnke and colleagues are reporting the outcomes of action-research study for a cohort of participants. The first and foremost important outcome of this study is the confirmation that the current design of the IPL and rehabilitation program are altogether leading to an acceptable rate of deep infection and other adverse events (e.g., structural failure of implant, periprosthetic factures). This study is also providing a strong insight onto the effect of major phases in redesign of an implant on the risk of infection. This is an important reminder that the development of a successful osseointegrated implant is unlikely to be immediate but the results of a learning curve made of empirical and sequential changes led by a reflective clinical practice. Clearly, this study provided better understanding of the safety of the ILP surgical and rehabilitation procedure while establishing standards and benchmark data for future studies focusing on design and infection of press-fit implants. Complementary observations of relationship between infection and cofounders such as loading of the prosthesis and prosthetic components used would be beneficial.Further definitive evidences of the clinical benefits with the latest design would be valuable, although an increase in health related quality of life and functional outcomes are likely to be confirmed. Altogether, the authors are providing compelling evidence that bone-anchored attachments particularly those relying on press-fit implants are an established alternative to socket prostheses.

Understanding mental toughness in Australian soccer: Perceptions of players, parents, and coaches

We explored mental toughness in soccer using a triangulation of data capture involving players (n = 6), coaches (n = 4), and parents (n = 5). Semi-structured interviews, based on a personal construct psychology (Kelly, 1955/1991) framework, were conducted to elicit participants' perspectives on the key characteristics and their contrasts, situations demanding mental toughness, and the behaviours displayed and cognitions employed by mentally tough soccer players. The results from the research provided further evidence that mental toughness is conceptually distinct from other psychological constructs such as hardiness. The findings also supported Gucciardi, Gordon, and Dimmock's (2009) process model of mental toughness. A winning mentality and desire was identified as a key attribute of mentally tough soccer players in addition to other previously reported qualities such as self-belief, physical toughness, work ethic/motivation, and resilience. Key cognitions reported by mentally tough soccer players enabled them to remain focused and competitive during training and matches and highlighted the adoption of several forms of self-talk in dealing with challenging situations. Minor revisions to Gucciardi and colleagues' definition of mental toughness are proposed.