Prevalence of gender-based and sexual harassment within orthopedic surgery in Canada.

BACKGROUND: Gender-based and sexual harassment are prevalent in the medical profession. We aimed to quantify the prevalence of such behaviours within orthopedic surgery in Canada and to identify any risk factors for experiencing gender-based or sexual harassment in the workplace. METHODS: In collaboration with the Canadian Orthopaedic Association, we conducted a Canada-wide email questionnaire survey in June 2019 of all orthopedic surgeons registered with the Canadian Orthopaedic Association and the Canadian Orthopaedic Residents' Association. The development of our questionnaire was informed by a review of the literature and published surveys on gender-based and sexual harassment, and consultation with researchers in intimate partner violence. We conducted a multivariable logistic regression analysis to identify risk factors for harassment. RESULTS: Of the 1783 surgeons invited to participate, 465 returned the questionnaire (response rate 26.1%); the response rate was 48.1% for females and 22.1% for males. Overall, 331/433 respondents (76.4%, 95% confidence interval [CI] 72%-80%) and 315/423 respondents (74.5%, 95% CI 70%-78%) reported having experienced at least 1 occurrence of gender-based and sexual harassment, respectively. Women were significantly more likely than men to have experienced both gender-based and sexual harassment (odds ratio [OR] 16.2, 95% CI 4.8-54.0, and OR 2.2, 95% CI 1.2-4.0, respectively). Respondents who identified as nonwhite were significantly less likely than those who identified as white to have experienced gender-based harassment (OR 0.5, 95% CI 0.3-0.99). CONCLUSION: The prevalence of gender-based and sexual harassment is high within Canadian orthopedic surgery, and women are at highest risk for experiencing harassment. The results may provide the impetus for orthopedic societies to develop action plans and to re-examine and enforce policies to address these damaging behaviours appropriately.

Mistreatment, discrimination and burn-out in Neurosurgery.

OBJECTIVE: Issues concerning harassment, bullying and discrimination are not unknown to medical specialties and are likely to be present in neurosurgery as well. The aim of this study was to estimate the extent to which neurosurgeons are faced with issues pertaining to this mistreatment. METHODS: A survey consisting of fourteen questions was distributed among members of the Congress of Neurological Surgeons (CNS). The survey consisted of three parts: 1) demographics; 2) exposure to mistreatment; 3) experienced burnout symptoms. RESULTS: In total 503 out of the 5665 approached CNS members filled in a survey (response rate 8.9 %). Respondents consisted for 85.9 % out of neurosurgeons and for 13.9 % out of residents. Overall, 61.4 % of the respondents was a victim of form of abusive behavior, while 47.9 % was a victim of at least one form of discrimination. Most reported sources of these mistreatments were other neurosurgeons or (family of) patients. Overall, 49.9 % of the respondents experienced burnout symptoms. Multivariable logistic regression analysis showed that female respondents had higher odds of being a victim of abuse (OR 2.5, 95 % CI 1.4-4.6). Female respondents (OR 19.8, 95 % CI 8.9-43.9) and ethnic minorities (OR 3.8, 95 % CI 2.3-6.2) had higher odds of being a victim of discrimination. Furthermore, victims of abuse were at higher odds (OR 1.7, 95 % CI 1.1-2.6) of having burnout symptoms. CONCLUSIONS: Mistreatment and experiencing burnout symptoms frequently occurs among neurosurgeons and residents.

Women in Otolaryngology: Experiences of Being Female in the Specialty.

OBJECTIVES: A broad survey of women otolaryngologists on the current state of the field, including opportunities for advancement, support of family leave, and prevalence of harassment, has not been performed since 1998. An update on the experiences of female otolaryngologists is vital to continue to advance the specialty. STUDY DESIGN: Anonymous web-based survey. METHODS: Survey of members of the Women in Otolaryngology (WIO) section of the American Academy of Otolaryngology-Head and Neck Surgery (all members of the AAO-HNS that identify as female are automatically members of this section). Distributed via AAO-HNS. RESULTS: Five hundred thirty-five responses out of 2303 total WIO members (response rate of 23.2%). Respondents ranged in age from 25 to >65 years. Respondents reported that in the residency programs they attended, 29% of residents, 13% of faculty, and 7% of department leaders were women. Forty-four percent disagreed that their department leaders and 39% disagreed that their male co-residents were supportive of women starting families in training. Younger respondents were more likely to feel that their department leaders were supportive of female residents, maternity leave, etc. Harassment in the current work environment did not differ by age; 53% reported harassment-free, 31% subtle undertones, 8% noticeable tones, 2% significant harassment. Harassment in the workplace varied by region; the greatest level of harassment was in the Midwest. CONCLUSIONS: Women otolaryngologists continue to experience harassment in the workplace. It is encouraging that younger otolaryngologists feel more supported by their departments in both their careers and their personal lives. This survey highlights critical areas for continued growth within our specialty. LEVEL OF EVIDENCE: IV Laryngoscope, 131:E380-E387, 2021.

'It comes with the territory' - Staff experience with violation and humiliation in mental health care - A mixed method study.

BACKGROUND: The aim of this study was to investigate staff's experiences with violation and humiliation during work in mental health care (MHC). A total of 1160 multi-professional MHC staff in Norway responded to an online questionnaire about their experiences with different kinds of violation and humiliation in the MHC setting. In addition, a sample of professionals (eight MHC nurses) were recruited for in-depth individual interviews. METHOD: The study used an explorative mixed method with a convergent parallel design; this included a web-based questionnaire to MHC staff in combination with individual interviews. The sample is considered to be equivalent to staff groups in MHC in Norway. RESULTS: Between 70 and 80% of the staff reported experiencing rejection, being treated with disrespect, condescending behaviour or verbal harassment. Male workers were significantly more often victims of serious physical violence, and women were significantly more often targets for sexual harassment. In interviews, participants said they considered being exposed to violence and humiliation to be part of the job when working in MHC, and that experience, as well as social support from colleagues, helped MHC practitioners to cope better with violent situations and feel less humiliated at work. DISCUSSION: A high amount of MHC staff report experiences of being violated and humiliated during work. The participants' perceptions of the users and their behaviour seem to influence their experience of feeling violated and humiliated. Knowledge about the dynamics of aggression between staff and users in MHC may be used in safeguarding staff and users, prevent coercion and heighten the quality of care.

Analyzing and learning the language for different types of harassment.

THIS ARTICLE USES WORDS OR LANGUAGE THAT IS CONSIDERED PROFANE, VULGAR, OR OFFENSIVE BY SOME READERS. The presence of a significant amount of harassment in user-generated content and its negative impact calls for robust automatic detection approaches. This requires the identification of different types of harassment. Earlier work has classified harassing language in terms of hurtfulness, abusiveness, sentiment, and profanity. However, to identify and understand harassment more accurately, it is essential to determine the contextual type that captures the interrelated conditions in which harassing language occurs. In this paper we introduce the notion of contextual type in harassment by distinguishing between five contextual types: (i) sexual, (ii) racial, (iii) appearance-related, (iv) intellectual and (v) political. We utilize an annotated corpus from Twitter distinguishing these types of harassment. We study the context of each kind to shed light on the linguistic meaning, interpretation, and distribution, with results from two lines of investigation: an extensive linguistic analysis, and the statistical distribution of uni-grams. We then build type- aware classifiers to automate the identification of type-specific harassment. Our experiments demonstrate that these classifiers provide competitive accuracy for identifying and analyzing harassment on social media. We present extensive discussion and significant observations about the effectiveness of type-aware classifiers using a detailed comparison setup, providing insight into the role of type-dependent features.

La mujer en Cirugía: una exploración de las barreras en la carrera laboral / Women in surgery: an exploration of career barriers

Antecedentes: las cirujanas en la Argentina experimentan barreras en el ámbito laboral y personal tratando de lograr sus objetivos profesionales. El objetivo de esta investigación fue explorar las barreras que enfrentan las cirujanas en su carrera laboral en las tres principales ciudades de la República Argentina. Material y métodos: estudio exploratorio transversal. Se utilizaron encuestas anónimas a cirujanas durante un período de 6 meses. Resultados: un 59% de las cirujanas son solteras y no viven en pareja. Aquellas con hijos son las principales encargadas de la crianza. Los esposos o convivientes aparecen en tercer lugar, con un muy bajo porcentaje de responsabilidad en la tarea. En la mayoría de los espacios laborales no existe un sistema que facilite el cuidado de hijos en su trabajo. El 65% afirma haber dejado de presentar trabajos científicos luego de la maternidad. Solo un 26% de los pacientes ha rechazado sus servicios en favor de ser intervenido por un cirujano hombre. Por el contrario, un 42% de los jefes ha rechazado ser acompañado en cirugías por cirujanas. Casi un 85% de las cirujanas ha recibido comentarios alusivos a su sexualidad durante su trabajo. Conclusión: las estructuras organizacionales quirúrgicas operan como un marco normativo estructurador de prácticas y discursos que han construido, en el nivel simbólico, subjetivo e institucional, las desigualdades entre mujeres y varones en el ámbito de la actuación médica. La feminización del sector en los últimos tiempos y la salida de la mujer al ámbito laboral no implican necesariamente la equidad de género.

Background: Women surgeons in Argentina face barriers in the workplace and in their personal life when trying to achieve their professional goals. The aim of this investigation was to explore the career barriers women surgeons face in the three main cities of Argentina. Material and methods: We conducted an exploratory cross-sectional study. Anonymous surveys were administrated to women surgeons during a six-month period. Results: Among survey respondents, 59% were single and did not live with a partner. Those with children are the primary carers. Spouses or partners appear in third place, with a very low percentage of responsibility as carers. Most workplaces where female surgeons work do not have childcare facilities. Sixty-five percent of the survey respondents had not presented scientific papers after having children. Only 26 percent of patients had rejected their services in favor of a male surgeon and 42% of head surgeons had refused to be assisted by female surgeons. Almost 85% of women surgeons have received comments about their sexuality during their work. Conclusions: The organizational structures of surgery departments work as a structured regulatory framework of practices and speeches that have constructed the inequalities between women and men in the field of medical action at the symbolic, subjective and institutional level. The recent feminization of the surgical field and the entrance of women in the workplace do not necessarily imply gender equality.

High Suicide Rates Among Unaccompanied Minors/Youth Seeking Asylum in Sweden.

Background and aim: We aimed to assess rates and background factors of suicide among unaccompanied minors/youth (10-21 years of age) seeking asylum in Sweden in 2017, and to compare these rates with rates in the Swedish general population of the same age. Method: Data were collected and validated using information from four governmental agencies and two nongovernmental organizations. Suicide rates were calculated for 100,000 individuals. Results: The suicide rate was 51.2 per 100,000 among unaccompanied minors/youth, which compares to 6.1 per 100,000 in the host population. Characteristics of asylum seekers who died by suicide were: male gender (100%) and from Afghanistan (83%). Hanging was the predominant method (60%). Limitations: As estimation of an exact population of asylum seekers is difficult; we overestimated the number of individuals in the population of asylum seekers, resulting in an underestimation of their suicide rates. Conclusion: The suicide rate in unaccompanied minors/youth seeking asylum in 2017 in Sweden can be regarded as very high. Rapid implementation of suicide preventive measures is warranted.

Disruptive behaviors among nurses in Israel - association with listening, wellbeing and feeling as a victim: a cross-sectional study.

OBJECTIVES: To examine the association between listening and disruptive behaviors and the association between disruptive behavior and the wellbeing of the nurse. To test whether constructive and destructive listening has an incremental validity. METHODS: A structured questionnaire survey that measured the (constructive & destructive) listening climate at work, exposure to disruptive behaviors, well-being and feeling as a victim. We presented this survey using the Qualtrics software. RESULTS: Of the final sample of 567 respondents who reported that they were nurses, MAge = 38.41, 67% indicated that they were exposed to some form of disruptive behavior. Experiencing listening in the ward was associated with low levels of exposure to disruptive behaviors; exposure to disruptive behaviors, in turn, predicted reduction in the nurses' wellbeing; the reduction in wellbeing was especially pronounced among nurses who felt like a victim. Each of the facets of the listening measure-constructive listening and destructive listening-had incremental validity in predicting exposure to disruptive behaviors. Finally, the effect of exposure to disruptive behavior on wellbeing was curvilinear. CONCLUSIONS: Disruptive behavior is a major challenge to the workplace well-being for nurses. The victim mentality has an adverse impact on nurses. Preventive efforts aimed at reducing disruptive behaviors among nurses and decreasing their sense of victimization are crucial for the well-being of nurses.

Workplace violence against doctors involved in clinical care at a tertiary care hospital in Pakistan.

A study was conducted to determine perceptions, attitudes and experience of workplace violence among residents and faculty at a tertiary care centre in Karachi, Pakistan. An anonymous, electronic, self-administered questionnaire was circulated among all residents and faculty members working at Aga Khan University Hospital, Karachi. A standard questionnaire was devised and used, and workplace violence and its types were defined as per World Health Organization (WHO) definitions. An overall response rate of 44.9% was achieved. A total of 53.4% of the respondents reported being victims of some form of workplace violence with verbal abuse being the most prevalent (41.6%) followed by bullying and threat. Most frequent perpetrators were found to be faculty members followed by patients or their attendants. Specialty of respondents was found to be significantly associated with verbal abuse and significantly more females were subjected to sexual harassment, while ethnicity was found to be significantly associated with racial harassment. The results correspond to previously available literature, while they also highlight some findings unique to our culture. We suggest that measures should be taken as per WHO and Joint Commission International Accreditation ( J CIA) recommendations to prevent workplace violence across the country.

Sexual harassment and victimization of students: a case study of a higher education institution in South Africa.

INTRODUCTION: Sexual harassment has been identified as a major public health problem that is hidden in most institutions/organizations. OBJECTIVE: This study assessed sexual harassment and victimization of students in a higher institution in South Africa. METHODS: A quantitative, cross-sectional descriptive design was used in this study. The target population was registered students of the higher education institution and the sample size was 342. Questionnaire was used for data collection and data were analyzed using Statistical Package for Social Sciences (SPSS) Version 23.0 program. The basic principles of ethics were duly observed and the ethical clearance certificate was obtained prior to data collection. RESULTS: The findings revealed that 27 (17.3%) of the male and 47 (25.5%) of the female respondents (P = 0.047) had personally experienced unwanted touching. Two (1.3%) male and 5 (2.7%) female students admitted that they have been raped. Seventeen (10.8%) of the males and 19 (10.2%) of the females had been coerced to comply with a sexual relationship on campus. CONCLUSION: This study shows that both male and female students on campus are experiencing different forms of sexual harassment.

[Scale Development on Perception of Academic Harassment among Medical University Faculties].

OBJECTIVES: In academia, harassment may often occur and remain unrevealed in Japan, which discourages young researchers from pursuing their career. It is necessary to estimate and improve the perception of "academic harassment" among university faculties. Therefore, in this study, we aim to develop a scale of perception of academic harassment. METHODS: Prior to a quantitative survey, a task team consisting of medical doctors, researchers, nurses, hospital workers, and managers in general affairs division identified 36 items related to academic harassment. In February 2016, we sent a self-administered questionnaire to 1,126 academic faculty members who worked in a medical university located in Tokyo, Japan. We instructed them to score the extent to which they consider each item as related to academic harassment based on a Likert scale. We carried out maximum likelihood factor analyses with promax rotation and computed Cronbach's alpha to develop a scale and investigate the reliability of the scale. RESULTS: In total, 377 returned the questionnaires (response rate, 33.5%; male, 73.8%). In factor analyses, we removed 17 items owing to low factor loadings, and four factors were eventually extracted. The first factor was termed "Harassment in organization (7 items)" because it included conditions of forcing a particular person to work on chores or lectures for students that may prevent one's academic research outputs. The second factor was termed "Violence and denying personal character (4 items)". The third factor was termed "Research misconduct (5 items)" including conditions of excluding a particular person from the coauthor list of research outputs or pressuring a person to fabricate, falsify, or plagiarize research outputs. The fourth factor was termed "Research interference (3 items)" including a condition of interference with conference attendance. Cronbach's alpha values of these four factors ranged from 0.83 to 0.91, suggesting that the scale had high reliability. The means of these factors did not differ according to gender but were higher in participants aged 50 or older than in younger participants. CONCLUSIONS: The results suggest that the scale of perception on academic harassment consisting of four factors with 19 items is valid and reliable to some extent.

Screening for Harassment, Abuse, and Discrimination among Surgery Residents: An EAST Multicenter Trial.

Estimating the prevalence of harassment, verbal abuse, and discrimination among residents is difficult as events are often under-reported. The purpose of this study was to determine the prevalence of discrimination and abuse among surgical residents using the HITS (Hurt, Insulted, Threatened with harm or Screamed at) screening tool. A multicenter, cross-sectional, survey-based study was conducted at five academic teaching hospitals. Of 310 residents, 76 (24.5%) completed the survey. The HITS screening tool was positive in 3.9 per cent. The most common forms of abuse included sexual harassment (28.9%), discrimination based on gender (15.7%), and discrimination based on ethnicity (7.9%). There was a positive correlation between individuals who reported gender discrimination and racial discrimination (r = 0.778, n = 13, P = 0.002). Individuals who experienced insults were more likely to experience physical threats (r = 0.437, n = 79, P < 0.001) or verbal abuse (r = 0.690, n = 79, P < 0.001). Discrimination and harassment among surgical residents in academic teaching hospitals across the United States is not uncommon. Further research is needed to determine the impact of these findings on resident attrition.

[Work related stress, sociological analysis]. / La souffrance au travail, réflexion sociologique.

Experienced on a personal and psychological level, work related stress nevertheless has social causes. New forms of management demand from staff an ever greater personal investment, but the growing intensification of the work often makes the missions they are given impossible to fulfil. This results in a feeling of having failed and of not being up to the job, which are in turn sources of suffering and stress.

[Moral harassment in the workplace and work related stress]. / Harcèlement moral en entreprise et souffrance au travail.

Work related stress may be caused by moral harassment or not. The law gives a precise definition of harassment, which constitutes a civil and criminal offence. This situation requires proof to be gathered and those responsible to be identified. In all cases, employees can protect themselves from harassment and seek help.

Risk Management with Clients Who Stalk, Threaten, and Harass Mental Health Professionals.

Although most psychologists will at some point be confronted with a client who engages in stalking, threatening, or harassing behavior (STHB), few feel prepared to manage these situations. In this article, the results of a survey of 112 psychologists who endorsed experiencing STHB are reported. Psychologists were asked about their perceptions of client motivations and personality pathology, frequency of use of 18 risk management responses, and perceived effectiveness of these responses. The effectiveness of risk management strategies differed by client level of personality organization and motivation for STHB. Some of the most commonly used risk management responses were among those most likely to result in adverse outcomes, particularly with certain types of clients. Efforts to develop empirically derived risk management strategies for clinicians confronted with STHB should integrate contextual variables, such as client personality and motivation.