Oaths, Conscience, Contracts, and Laws-The Gathering Storm Confronting Medical Professionalism.

This Viewpoint explains the 3 trends­personal conscience, employment contracts, and laws­that challenge physicians from putting their patients first and offers ways to reverse these barriers.

Gemeinsame Stellungnahme der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie (DGHNO-KHC) und des Deutschen Berufsverbandes der HNO-Ärzte (BVHNO) für ärztliches Personal in der Hals-, Nasen- und Ohrenheilkunde/Kopf- und Hals-Chirurgie zum Arbeiten in der Schwangerschaft und Stillzeit.

Working during pregnancy and breastfeeding is a special situation for both the employee and the employer/supervisor. The amended version of the Maternity Protection Act (MuSchG), which came into force on January 1st, 2018, protects the health of women and their children while working, training or studying during pregnancy, after giving birth and while breastfeeding. Women should be able to continue their employment or related activities during this time without jeopardising their health or that of their child. This law was furthermore reformed to prevent discrimination against the working mother during this time. In order to create the best and safest possible framework conditions for employment during pregnancy and breastfeeding, the DGHNO-KHC and the BVHNO would like to present a "general positive list" and a "positive list for surgical activities" as part of this statement, which should serve as a guideline for all relevant parties. This agreed positive list is intended to enable pregnant and breastfeeding doctors to carry out patient-related activities as well as head and neck surgeries in accordance with the MuSchG of 2018. Hereby, affected colleagues should have the opportunity to continue working self-determined.

Beyond minimum wage: Broader employment policies can significantly affect food insecurity.

Although many have investigated the impacts of minimum wage on a broad array of health outcomes, innovative policies surrounding broader employment policies have largely not been studied. To that end, this paper contributes in three ways. First, it discusses the rise in precarious employment. Then, it turns to the current federal framework of employment policies, namely minimum wage. Finally, it explores what a broader definition of employment policies could include and how future studies could use state, county, and municipal policymaking in this space to investigate ways in which they might contribute to reducing food insecurity and in turn, improve health outcomes.

About 30% of low-income households experienced food insecurity in 2023. Given that food security is strongly tied to employment conditions, there is potential to reduce food insecurity through innovative employment-focused policy changes. Minimum wage is often studied as an indicator of employment quality. However, employment policies now stretch beyond hourly rate, as several jurisdictions have adopted innovative, broader approaches to improving employment. More research is needed to determine whether these broader employment policies, such as secure scheduling, paid leave, and collective bargaining, may mitigate food insecurity.

Taming Proteus: Challenges for Risk Regulation of Powerful Digital Labor Platforms.

The platform economy's emergence challenges the current labor regulations hinged upon the binary employer-employee relations established during the industrial age. While this burgeoning phenomenon presents several possibilities for workers, customers, and businesses alike, scholars from various fields have sounded alarms regarding pitfalls in platform-mediated work (PMW). The regulation of working conditions, health, and safety risks are integral to these worries. Drawing upon existing research and empirical data from 49 qualitative interviews with several stakeholders, this paper explores the various dimensions of power exerted by platforms and the mismatch with the current risk regulatory framework. Four regulatory gaps are identified and the concept 'regulatory escape' is introduced. The study posits that taming powerful platforms requires harnessing adequate regulatory capacity grounded on developing an expansive view of regulation that encompasses all forms of socio-economic influence. The paper invokes reflection on the existing regulatory systems in society and calls for a more profound and inclusive debate on platform-mediated work and how regulatory gaps can be closed.

Os impactos da reforma trabalhista sobre o trabalho da enfermagem / Las repercusiones de la reforma laboral en el trabajo de enfermería / Impacts of the labor reform on nursing work

RESUMO Objetivo: refletir acerca das transformações ocorridas no universo do trabalho da Enfermagem, à luz da Reforma Trabalhista de 2017. Metodologia: trata-se de uma produção teórica de reflexão, suportada pela sociologia do trabalho e por estudos da Enfermagem e da Saúde Coletiva sobre a dimensão do trabalho. Divide-se em três tópicos: o primeiro localiza a Enfermagem no âmbito da reestruturação produtiva do Estado brasileiro na década de 1990; o segundo apresenta o perfil dos profissionais no Brasil; o terceiro explana as repercussões da Reforma Trabalhista de 2017 no universo do trabalho da Enfermagem. Resultados: as alterações geradas pela Reforma Trabalhista apontam para uma perspectiva de vínculos mais precários e desprotegidos de trabalho, os quais comprometem a luta dos profissionais da Enfermagem e produzem adoecimento. Considerações Finais: este estudo possui potencial para subsidiar o debate sobre a temática e a reflexão dos profissionais da Enfermagem, diretamente afetados, sobre as estratégias para superação desses desafios.

RESUMEN Objetivo: reflexionar sobre las transformaciones ocurridas en el universo laboral de la Enfermería, a la luz de la Reforma Laboral de 2017. Metodología: se trata de una elaboración teórica de reflexión, apoyada en la sociología del trabajo y en estudios de Enfermería y Salud Colectiva sobre la dimensión del trabajo. Se divide en tres temas, el primero ubica a la Enfermería en el contexto de la reestructuración productiva del Estado brasileño en la década de los 90's; el segundo presenta el perfil de los profesionales en Brasil; el tercero, las repercusiones de la Reforma Laboral de 2017 en el universo del trabajo de Enfermería. Resultados: los cambios generados por la reforma laboral apuntan a una perspectiva de vínculos laborales más precarios y desprotegidos que comprometen la lucha de los profesionales de Enfermería y producen enfermedad. Consideraciones finales: este estudio tiene el potencial de subvencionar el debate sobre el tema y la reflexión de los profesionales de enfermería, directamente afectados, sobre las estrategias para superar estos retos.

ABSTRACT Objective: to reflect on the changes that took place in the Nursing work universe, in the light of the 2017 Labor Reform. Methodology: this is a reflection theoretical production supported by Labor Sociology and by Nursing and Collective Health studies dealing with the work dimension. It is divided into three topics: the first locates Nursing in the context of the productive restructuring of the Brazilian State in the 1990s; the second presents the profile of professionals in Brazil; the third explores the repercussions of the 2017 Labor Reform in the universe of Nursing work. Results: the changes generated by the Labor Reform point to a perspective of more precarious and unprotected work contracts, which compromise the struggle of Nursing professionals and produce illness. Final Considerations: this study has the potential to subsidize a debate about the theme and reflection in the Nursing professionals, directly affected, about the strategies to overcome these challenges.

Employer Vaccine Mandates.

What nurses need to know as hospitals institute COVID-19 vaccine mandates.

Understanding the Basics of Restrictive Covenants in Employment Agreements.

BACKGROUND: Restrictive covenants are common in contractual agreements involving physicians and need careful consideration to minimize potential conflict during the term of the contract and on physician departure from a group practice or hospital system. METHODS: A general overview of the different components of restrictive covenants is provided, including specific information related to noncompetes, nonsolicitations, and nondisclosure agreements. RESULTS: In general, states will uphold restrictive covenants if the elements of the noncompete are reasonable regarding geographic distance restrictions (e.g., <20 air miles), time restrictions (e.g., <2 years), and scope of services. However, states vary considerably in the interpretation of restrictive covenants. Other components of the contract, such as alternative dispute resolution (mediation and/or arbitration) and buy-out clauses (i.e., liquidated damages provisions), should be considered at the time the agreement is negotiated. CONCLUSIONS: States are balancing the protection of business interests with the protection of free trade. It is important that physicians seek counsel with an experienced health care attorney with respect to restrictive covenants in his or her specific state. A simple, well-written, and reasonable restrictive covenant can often help limit legal conflict and expense.

Are You Ready to Negotiate Your First Employment Contract? Experience of More Than 700 Plastic Surgeons.

BACKGROUND: Plastic surgeons have been shown to be unprepared to negotiate their first employment contracts. Previous survey studies have attempted to assess plastic surgeons' first employment contracts to outline common pitfalls in contract negotiation. With this study, the authors aim to expand these previous studies and help plastic surgeons become prepared to negotiate their employment contracts. METHODS: A seven-question, cross-sectional survey was sent to attending-level surgeon members of the California Society of Plastic Surgeons, the American Society of Plastic Surgeons, the Texas Society of Plastic Surgeons, and the American Cleft Palate-Craniofacial Association. Questions investigated plastic surgeons' first contracts. Correlations were determined using a two-sample Wilcoxon rank sum test in an attempt to link these questions with overall satisfaction. RESULTS: From the 3908 distributed surveys, 782 (20 percent) responses were collected, and 744 were included for analysis. The majority of respondents were found to join a group-centered, private practice following residency. Surprisingly, 69 percent of surgeons did not use attorney assistance when negotiating their contract. Although greater than 70 percent of respondents reported a salary of $200,000 or less, satisfaction with one's contract was most strongly correlated with a salary of greater than $300,000 (p < 0.0001). However, only 12 percent of respondent surgeons were able to secure such a salary. CONCLUSIONS: This study examined the largest, most diverse plastic surgeon cohort to date regarding surgeons' first employment contract. Although the authors' findings indicate that certain factors should be prioritized when approaching a first employment contract, they ultimately recommend that all surgeons take into account their personal priorities and attempt to proactively define their terms of employment before signing a contract.

Health and Safety in the Legal Cannabis Industry Before and During COVID-19.

In 2020, medical cannabis is legal in thirty-six states and adult use ("recreational") cannabis is legal in fifteen, despite cannabis remaining illegal at the federal level. Up to 250,000 individuals work as full-time employees in cannabis. During the COVID-19 pandemic, California, Colorado, and other states deemed medical cannabis business as essential, raising occupational challenges and safety issues for cannabis employees. In 2020, interviews were conducted with Ethan, an extraction lab assistant in Las Vegas; Haylee, a trainer with a cannabis company in Sacramento; and Belinda, a Wisconsin-based occupational health and safety trainer, to showcase concerns and experiences in cannabis workplaces and training programs. Findings from interviews reveal pro-worker activities to promote workplace safety and labor unionism while large multistate operators seek to optimize profits and obstruct workers' rights. Knowledge gained through the interviews contributes to discussions to lessen the potential exposure of the cannabis workforce to COVID 19.

Neoliberalism: Unpacking Limited Employment Success for Persons with SMI.

BACKGROUND.: A mixed-methods case study exploring access to competitive employment for persons with serious mental illness (SMI) revealed limited access to work and low employment success across two northern communities. PURPOSE.: To explore possible explanations for why low employment rates persist despite existing employment services and supports. METHODS.: A total of 46 individual or group interviews were conducted with persons with SMI, vocational providers, and decision-makers regarding access to competitive employment in the case communities. Data were systematically analysed for dominant ideas, interests and institutions using a neo-institutional framework. FINDINGS.: Participants described access to employment to be constrained by provider competition, limited supports, and a lack of consideration of difference-ideas and interests associated with neoliberal influences within provincial employment supports policy. IMPLICATIONS.: Enabling participation in meaningful employment for people with SMI will require occupational therapists to appreciate and contest the oppressive nature of neoliberal policies on local programs and services.

The influence of COVID-19 on agricultural economy and emergency mitigation measures in China: A text mining analysis.

Understanding the influence of COVID-19 on China's agricultural economy and the Chinese government's emergency measures to ease the economic impacts of viral spread can offer urgently-needed lessons while this virus continues to spread across the globe. Thus, this study collected over 750,000 words upon the topic of COVID-19 and agriculture from the largest two media channels in China: WeChat and Sina Weibo, and employed web crawler technology and text mining method to explore the influence of COVID-19 on agricultural economy and mitigation measures in China. The results show that: (1) the impact of COVID-19 on China's agricultural economy at the very first phase is mainly reflected in eight aspects as crop production, agricultural products supply, livestock production, farmers' income and employment, economic crop development, agricultural products sales model, leisure agriculture development, and agricultural products trade. (2) The government's immediate countermeasures include resuming agricultural production and farmers' work, providing financial support, stabilizing agricultural production and products supply, promoting agricultural products sale, providing subsidies, providing agricultural technology guidance and field management, and providing assistance to poor farmers to reduce poverty. (3) The order of government's immediate countermeasures is not all in line with the order of impact aspects, which indicates that more-tailored policies should be implemented to mitigate the strikes of COVID-19 on China's agricultural economy in the future.