"Opportunities and responsibilities": how do pharmacists assess their professionalism?

INTRODUCTION: Professionalism is fundamental to the existence of professions. In pharmacy, interest in this theme improved with events that examined the resocialization of pharmacists in care. With this, evaluating professionalism can help the operationalization of the theme and, consequently, the development of strategies for pharmacy consolidation before its challenges. Therefore, this study aimed to evaluate the professionalism of Brazilian pharmacists. METHODS: To meet the objective, a cross-sectional study was conducted between March 2022 and August 2023. Data were collected using the Brazilian version of the "Modification of Hall's Professionalism Scale for Use with Pharmacists". The scale has 39 items grouped into the domains: autonomy, vocation, professional council, self-regulation, continuing education, and altruism. Data were analyzed using descriptive statistics and an ANOVA analysis of variance with post-hoc Hochberg or Games-Howell tests with Bootstrapping was conducted to verify differences between groups. RESULTS: 600 pharmacists participated in this study. The majority (69%) was female and carried out their professional activities in community pharmacies (50%). Professionalism scores ranged between 14 and 29 points, with an average of 22.8 points. Pharmacists working in outpatient clinics had higher scores in most factors, namely, altruism, continuing education, professional council, vocation, and autonomy. This indicates that the inclination of pharmacists to occupy areas focused on care can be significant to assess professionalism. CONCLUSIONS: The data obtained indicate that pharmacists working in outpatient clinics had higher professionalism scores compared to others. This corroborates the worldwide trend experienced by pharmacy in recent decades, which is the execution of increasingly patient-centered practice models.

Improving vocational guidance through an expert system: Temporary decreasing and enhancing student self-awareness.

Background: The vocational guidance process in educational institutions faces important challenges in managing trials and errors in diagnoses. Technological tools are identified as an effective solution to address these problems. This research seeks to improve career guidance in educational institutions through the implementation of an expert system. The main objective is to reduce test processing time and achieve greater efficiency in students' self-knowledge regarding their interests, based on the personalities of the Holland Test. Methods: The development of the expert system followed a six-model approach. First, an organisational model was created to assess the scope and feasibility of the project. Next, a task and agent model was developed to investigate the impact and look for improvements. A knowledge model was then developed to analyse the relevant knowledge bases. A communication model was also developed to evaluate the communication interface of the system. Next, a design model was created to provide guidelines for the implementation of the system. Finally, the implementation of the knowledge system was carried out to ensure its correct functioning. Results: The implementation of the expert system has shown significant improvements in the vocational guidance process. It was possible to reduce the time needed to apply the test, thus optimising the psychologist's time and allowing a greater capacity for analysis. In addition, an improvement in the effectiveness of the students' self-knowledge in relation to their vocational interests based on the personalities of the Holland Test was observed. Conclusions: This study contributes to career guidance in educational institutions by introducing an innovative expert system. This technological solution optimizes the career guidance process, benefiting psychologists administering tests and students seeking self-knowledge about their career interests.

Assessing cognitive communication skills for returning to work following acquired brain injury: a systematic scoping review.

PURPOSE: Cognitive communication impairments resulting from acquired brain injury (ABI) impact a person's ability to return to and maintain employment. This study reviews the assessment of cognitive communication skills for return to work after injury. MATERIALS AND METHODS: A scoping review was conducted. Key search terms included brain injury, cognitive communication, work and their synonyms. Studies were included if participants had an ABI diagnosis, were at least 16 years old, mentioned vocational rehabilitation or return to work, and cognition or cognitive communication. RESULTS: A total of 692 studies were identified through database searches with an additional 18 articles found through handsearching. Fourteen articles were included in the final review. Measures, most included in studies target discrete skills when aligned to the Model of Cognitive Communication Competence. The Individual and Contextual Domains of the model were not well represented and there were limited measures able to capture self or other reported data. CONCLUSIONS: Assessment of cognitive communication skills for returning to work following ABI requires an individualised and contextualised approach. This study highlights a gap between key clinical models and measures reported in the current literature. Further research into clinical practice is required.

Research into resources to help clinicians capture information related to the individual, their role and work environment are needed to support contextualised assessment for return to work.The multifactorial nature of communication should be considered when assessing cognitive communication for return to work. Models such as the Model of Cognitive Communication Competence are available.Measures such as the Functional Assessment of Verbal Reasoning and Executive Strategies and the La Trobe Communication Questionnaire can be considered.

Vocation as tragedy: Love and knowledge in the lives of the Mills, the Webers, and the Russells.

Can love affect knowledge and knowledge affect love? John Stuart Mill and Harriet Taylor-Mill, Max and Marianne Weber, and Bertrand and Dora Russell had a definite vocation: they wanted to change the world. They questioned traditional gender arrangements through publications on equality, marriage, and education. They were liberal thinkers, advocating individual freedom and autonomy, vis à vis the constraints of state and society. Their partnership inspired their work, a living experiment conducted through their own unconventional relationship. Over time, their increasingly radical, avant-garde ideas on marriage complicated the ongoing negotiation over power and intimacy which typified their marriages. Building on the historiography of social science couples, and by means of an analysis of the micro-social dynamics of marriage as documented in the life writings of the Mills, the Webers, and the Russells, I analyse the connections between gender, intimacy, and creativity. These couples' experiences highlight the non-rational dimension of a most rational endeavour.

Virtues and vocation: An historical perspective on scientific integrity in the twenty-first century.

According to the Dutch chemist Gerrit Jan Mulder (1802-1880), the principal aim of university education was character building and moral edification. Professional training was of secondary importance. Mulder's ideas about the vocation and moral mission of the university professor can serve as a historical counterpart to later Weberian, Mertonian, and contemporary ideas on the ethos of science. I argue that a revaluation of the moral precepts that Mulder saw as defining the life of an academic is helpful in dealing with the problems of late modern science, such as the replication crisis and research misconduct. Addressing such problems must start in the university classrooms. To empower students to internalize the principles of responsible conduct of research, we need an updated version of Mulder's idea of the university professor as a moral agent.

Specialists with spirit: Re-enchanting the vocation of science.

This article is both a comment on the collection of papers, "Specialists with Spirit: Re-Enchanting the Vocation of Science," offered as a tribute to Klaas van Berkel, and an attempt to add historical depth to present-day sensibilities about the academic discipline called the history of science: Is it a special sort of inquiry? Is science as its subject matter a special sort of culture? Max Weber's 1917 Science as a Vocation lecture, and its continuing appropriations, is a focal point for addressing these questions.

Editorial: Re-enchanting the vocation of science.

This editorial introduces the collection, "Specialists with Spirit: Re-Enchanting the Vocation of Science," co-edited by Dorien Daling and Hanneke Hoekstra. The collection offers a tribute to the eminent historian of science, Klaas van Berkel, commemorating his retirement from the University of Groningen. The papers compel us to consider the ongoing tensions between knowledge production and the social, political, and economic constraints faced by scholars, a theme that Max Weber famously addressed in his 1917 lecture, Wissenschaft als Beruf, which the collection's contributors revisit as they consider a range of historical and contemporary questions concerning science and its study by historians.

Recovery of functional independence following major burn: A systematic review.

BACKGROUND: Major burn injury, despite advancements in care and prevention, can have a profound impact on long-term morbidity, affecting quality of life and socioeconomic standing. We aim to explore factors predicting recovery of independence, the expected rate and time in majorly burned patients, and the measures of progress used. METHOD: A systematic search of four databases (MEDLINE, EMBASE, COCHRANE, CINAHL) was conducted for studies reporting outcomes pertaining to physical ability indicative of independent function in adult (>15 y) cohorts who had suffered a major burn (>20% TBSA) up to 30 years after treatment in a developed specialised burn service. Data extracted included factors affecting rate of and time to achievement of function in five independence domains, as well as the outcome measures used. RESULTS: 21 eligible studies were included comprising 1298 major burns survivors with a combined mean age of 39.6 y and a mean TBSA of 25.8%. The most significant recurring factors impacting recovery of independent function were older age, female gender, burn severity, prolonged ICU and hospital admission, preceding mental health conditions, and post-acute psychological issues. Exercise-based rehabilitation conferred benefits on major burn patients even over 2 years following injury. Discharge to independent living from hospital occurred in 27% to 97% of patients, while reported return to work rates varied from 52% to 80%. Burns Specific Health Scale-Brief, Functional Independence Measure, and Physical Composite Score (SF-36) were the most widely used outcome scoring systems. CONCLUSION: Major burn survivors have protracted recovery with potential for persistent chronic impairments, remaining consistently below baseline levels of function. Non-modifiable factors such as age and gender, and disease characteristics such as burn size with associated physical, physiological and psychosocial sequelae are contributory. Further research is required to explore achievement of specific milestones of major burn and polytrauma critical care patients, while early targeted rehabilitation addressing physical, psychological, and vocational needs has promising potential benefit.

Describing Outcomes in Autistic Young Adults One Year After High School Graduation.

PURPOSE: Research documents poor outcomes for autistic adults in the domains of employment, independent living, and social relationships. Measurement and sample limitations in prior studies may have amplified past estimates of poor outcomes. The goal of the current study was to improve upon past approaches and to create and describe a measurement approach to capture adult outcomes that reflected the context of young adulthood and the perspectives of autistic individuals, pairing objective outcome indicators with subjective satisfaction indicators. METHODS: Thirty-six autistic young adults (mean age 19.8 years) and a parent completed self-report surveys. Using these data, we defined an objective and subjective (i.e., satisfaction) outcome indicator in each of three domains: productivity (employment or post-secondary education), social well-being (frequency of contact with friends), and living situation (autonomy). RESULTS: Three-quarters of young adults experienced at least 5 out of 6 positive outcomes. Over 90% were engaged in school, work, or a structured transition program, and an equal percentage were satisfied with their productivity activity. Over three-quarters of adults had a good amount of contact with friends and were satisfied with their social life. Most young adults had a moderate level of autonomy in their daily lives, and all were satisfied with their living situation. CONCLUSION: Tailoring outcome measurement approaches specifically for autistic young adults provided a more optimistic portrayal of outcomes than previously noted in the literature. The approach used better reflects a neurodiversity approach and may be useful for evaluating the effectiveness of transition services or interventions.

Visualization of latent components assessed in O*Net occupations (VOLCANO): A robust method for standardized conversion of occupational labels to ratio scale format.

Occupations are typically characterized in nominal form, a format that limits options for hypothesis testing and data analysis. We drew upon ratings of knowledge, skills, and abilities for 966 occupations listed in the US Department of Labor's Occupational Classification Network (O*NET) database to create an accessible, standardized multidimensional space in which occupations can be quantitatively localized and compared. Principal component analysis revealed that the occupation space comprises three main dimensions that correspond to (1) the required amount of education and training, (2) the degree to which an occupation falls within a science, technology, engineering, and mathematics (STEM) discipline versus social sciences and humanities, and (3) whether occupations are more mathematically or health related. Additional occupational spaces reflecting cognitive versus labor-oriented categories were created for finer-grained characterization of dimensions within occupational sets defined by higher or lower required educational preparation. Data-driven groupings of related occupations were obtained with hierarchical cluster analysis (HCA). Proof-of-principle was demonstrated with a real-world dataset (470 participants from the Nathan Kline Institute - Rockland Sample; NKI-RS), whereby verbal and non-verbal abilities-as assessed by standardized testing-were related to the STEM versus social sciences and humanities dimension. Visualization of Latent Components Assessed in O*Net Occupations (VOLCANO) is provided to the research community as a freely accessible tool, along with a Shiny app for users to extract quantitative scores along the relevant dimensions. VOLCANO brings much-needed standardization to unwieldy occupational data. Moreover, it can be used to create new occupational spaces customized to specific research domains.

Language Skills Influence Transition Planning in Adolescents With Fragile X Syndrome.

Individuals with fragile X syndrome (FXS) and their parents have a range of experiences navigating the crucial transition period between adolescence and adulthood. Semistructured interviews of 47 mothers of adolescents with FXS (mean child age = 15.89 years) were analyzed to identify mothers' changing expectations during the adolescent period and parent goals related to work and postsecondary education. Mothers' work and education goals were explored in relation to child factors such as language skills and autism characteristics. Lower language skills were associated with lower likelihood of reporting vocational goals. Results suggest that adolescents with FXS with lower language ability are less likely to have vocational plans for adulthood during this critical period and may need greater transition planning assistance.

La promoción de la lectura y su relación con las vocaciones y entornos profesionales / Reading promotion and its association with professional vocations and care settings

Introducción: la promoción de hábitos de vida saludables es una práctica habitual entre los pediatras. Dentro de estos se encuentra la promoción de la lectura, que entraña numerosos beneficios para la infancia: estimula la actividad cerebral y su reserva cognitiva, aumenta la concentración y el desarrollo del lenguaje y permite trabajar las emociones. El objetivo de este estudio es conocer la realidad de la práctica de la promoción de la lectura desde las consultas de Pediatría, así como su relación con la vocación pediátrica (clínica, preventiva y social) y los entornos profesionales (residencia, hospital y Atención Primaria). Material y métodos: estudio transversal, descriptivo de ámbito nacional, mediante encuesta en línea a residentes de Pediatría, pediatras hospitalarios/as y de Atención Primaria llevado a cabo en marzo de 2022. Resultados: participaron 326 pediatras, un 16,8% hospitalarios/as, un 69,8% de Atención Primaria y 13,4% residentes de Pediatría. El 18,8% seleccionaron la vocación preventiva, el 60,8%, la clínica y el 20,5%, la social. Junto con una descripción detallada del tipo de actividades de promoción de la lectura que se realizan en nuestro país, los resultados mostraron, en primer lugar, que la vocación médica se relacionó con su mayor o menor realización (χ2(2) = 13,11, p <0,001), siendo los pediatras con vocación social los que informaron llevarlas a cabo en un mayor porcentaje. En segundo lugar, también el ámbito de trabajo apareció como un condicionante para la realización de estas actividades (χ2(2) = 19,0, p <0,001), que se llevan a cabo más frecuentemente en las consultas de Atención Primaria. Conclusiones: las actividades de promoción de la lectura son realizadas mayormente por los profesionales de Atención Primaria, en el marco de otras actividades de promoción de la salud, vinculadas principalmente con su mayor vocación por la Pediatría social. (AU)

Introduction: healthy lifestyle promotion is a common practice among paediatricians. Reading promotion is included in that practice. It has numerous benefits for children: it stimulates brain activity and cognitive reserve, improves concentration and language development and helps develop emotional skills.The aim of our study was to assess the implementation of reading promotion activities in real-world paediatric care practice, as well as its association with the underlying vocation for paediatrics (clinical, preventive or social) and the care setting (residency programme, hospital and primary care). Material and methods: cross-sectional, descriptive study of national scope through an online survey of paediatrics residents and hospital-based and primary care paediatricians carried out in March 2022. Results: 326 paediatricians participated, of who 16.8% worked in hospitals, 69.8% in primary care and were 13.4% paediatrics residents. Of this total, 18.8% reported a vocation for preventive care, 60.8% for clinical work and 20.5% for social paediatrics. In addition to carrying a detailed descriptive analysis of the type of reading promotion activities carried out in Spain, we found, firstly, that the vocation for medical practice was associated to the frequency of reading promotion (χ2(2)=13.11; p<0.001), with a higher proportion of paediatricians with a social vocation reporting performance of these activities. Secondly, the care setting also seemed to be a determining factor for the performance of these activities (χ2(2)=19.0; p<0.001), which were conducted more frequently in the primary care setting. Conclusion: activities to promote reading are carried out mainly by primary care professionals within the framework of other health promotion work, and their performance was mainly associated with the greater proportion of primary care professionals with a vocation for social paediatrics. (AU)

"On the ruins of seriality": The scientific journal and the nature of the scientific life.

Twenty-first-century discourse on science has been marked by narratives of crisis. Science is said to be experiencing crises of public trust, of peer review and publishing, of reproducibility and replicability, and of recognition and reward. The dominant response has been to "repair" the scientific literature and the system of scientific publishing through open science. This paper places the current predicament of scholarly communication in historical perspective by exploring the evolution of the scientific journal in the second half of the twentieth century. I focus on a new genre of scientific journal invented by Dutch commercial publishers shortly after World War II, and on its effects on the nature of the scientific life. I show that profit-oriented publishers and discipline-building scientists worked together to make postwar science more open, while also arguing that formats of scientific publication have their own agency.

Vocación médica, más allá del deber de cuidar: Revisión de la literatura desde el aspecto ético y filosófico

En este artículo de revisión, se examina la vocación médica como un fenómeno que va más allá del simple deber de cuidar a los pacientes y se centra en la importancia del compromiso ético, la empatía y la resiliencia en la práctica médica. Se discuten las implicaciones para la formación de médicos y la práctica clínica.

This review article explores medical vocation as a phenomenon that extends beyond the mere duty of caring for patients, focusing on the significance of ethical commitment, empathy, and resilience in medical practice. The implications for medical training and clinical practice are discussed.

Multisite Agricultural Veterans Affairs Farming and Recovery Mental Health Services (VA FARMS) Pilot Program: Protocol for a Responsive Mixed Methods Evaluation Study.

BACKGROUND: Veterans Affairs Farming and Recovery Mental Health Services (VA FARMS) is an innovative pilot program to provide supportive resources for veterans with interests in agricultural vocations. Implemented at 10 pilot sites, VA FARMS will provide mental health services and resources for veterans while supporting training in gardening and agriculture. As each pilot site project has unique goals, outreach strategies, and implementation efforts based on the local environment and veteran population, evaluating the pilot program provides a unique challenge for evaluators. This paper describes the protocol to evaluate VA FARMS, which was specifically designed to enable site variation by providing both site-specific and cross-site understanding of site implementation processes and outcomes. OBJECTIVE: The objectives of this paper are to (1) describe the protocol used for evaluating VA FARMS, as an innovative Department of Veterans Affairs (VA) agriculturally based, mental health, and employment pilot program serving veterans at 10 pilot sites across the Veterans Health Administration enterprise; and (2) provide guidance to other evaluators assessing innovative programs. METHODS: This evaluation uses the context, inputs, process, product (CIPP) model, which evaluates a program's content and implementation to identify strengths and areas for improvement. Data collection will use a concurrent mixed methods approach. Quantitative data collection will involve quarterly program surveys, as well as three individual veteran participant surveys administered upon the veteran's entrance and exit of the pilot program and 3 months postexit. Quantitative data will include baseline descriptive statistics and follow-up statistics on veteran health care utilization, health care status, and agriculture employment status. Qualitative data collection will include participant observation at each pilot site, and interviews with participants, staff, and community stakeholders. Qualitative data will provide insights about pilot program implementation processes, veterans' experiences, and short-term participation outcomes. RESULTS: Evaluation efforts began in December 2018 and are ongoing. Between October 2018 and September 2020, 494 veterans had enrolled in VA FARMS and 1326 veterans were reached through program activities such as demonstrations, informational presentations, and town-hall discussions. A total of 1623 community members and 655 VA employees were similarly reached by VA FARMS programming during that time. Data were collected between October 2018 and September 2020 in the form of 336 veteran surveys, 30 veteran interviews, 27 staff interviews, and 11 community partner interviews. Data analysis is expected to be completed by October 2022. CONCLUSIONS: This evaluation protocol will provide guidance to other evaluators assessing innovative programs. In its application to the VA FARMS pilot, the evaluation aims to add to existing literature on nature-based therapies and the rehabilitation outcomes of agricultural training programs for veterans. Results will provide programmatic insights on the implementation of pilot programs, along with needed improvements and modifications for the future expansion of VA FARMS and other veteran-focused agricultural programs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/40496.

Cancer survivors' financial hardship and their caregivers' employment: results from a statewide survey.

PURPOSE: Many caregivers take paid and/or unpaid time off work, change from full-time to part-time, or leave the workforce. We hypothesized that cancer survivor-reported material hardship (e.g., loans, bankruptcy), behavioral hardship (e.g., skipping care/medication due to cost), and job lock (i.e., staying at a job for fear of losing insurance) would be associated with caregiver employment changes. METHODS: Adult cancer survivors (N = 627) were surveyed through the Utah Cancer Registry in 2018-2019, and reported whether their caregiver had changed employment because of their cancer (yes, no). Material hardship was measured by 9 items which we categorized by the number of instances reported (0, 1-2, and ≥ 3). Two items represented both behavioral hardship (not seeing doctor/did not take medication because of cost) and survivor/spouse job lock. Odds ratios (OR) were estimated using survey-weighted logistic regression to examine the association of caregiver employment changes with material and behavioral hardship and job lock, adjusting for cancer and sociodemographic factors. RESULTS: There were 183 (29.2%) survivors reporting their caregiver had an employment change. Survivors with ≥ 3 material hardships (OR = 3.13, 95%CI 1.68-5.83), who skipped doctor appointments (OR = 2.88, 95%CI 1.42-5.83), and reported job lock (OR = 2.05, 95%CI 1.24-3.39) and spousal job lock (OR = 2.19, 95%CI 1.17-4.11) had higher odds of caregiver employment changes than those without these hardships. CONCLUSIONS: Caregiver employment changes that occur because of a cancer diagnosis are indicative of financial hardship. IMPLICATIONS FOR CANCER SURVIVORS: Engaging community and hospital support for maintenance of stable caregiver employment and insurance coverage during cancer may lessen survivors' financial hardship.

The Efficacy of Disability Employment Service (DES) Providers Working with Autistic Clients.

The efficacy of the Australian Disability Employment Services (DES) for autistic jobseekers has not been examined and is currently undergoing Government reform. To help inform the new DES strategy, we sought the views of: 24 autistic individuals; seven family members of autistic individuals, and; 46 DES employees. Data were collected using surveys and interviews. Data were analysed using Mann Whitney tests plus deductive thematic analysis based on Nicholas and colleagues' ecosystems model. Participants highlighted a need to adapt existing policies to enhance flexibility of the DES model. There was participant consensus that DES staff require specific education and training to meet the needs of autistic people. Suggestions to inform the new model of DES for autistic people are made.

A Vocation of Palliation.

I consider myself a "late bloomer," since I never encountered the practice of palliative care during medical school in the Philippines, nor during my internal medicine residency in the USA. It was 3 years into my first job after finishing residency, working both as a hospitalist and an urgent care physician, when I came to an early morning session on end-of-life care at a large medical society meeting. That talk changed my life. I now see palliative care as being more than a "profession" or a "medical specialty." It is my vocation, as serendipitous events called me into this line of work. For more than 5 years now, I have been practicing palliative care, both in the inpatient and outpatient settings, at our institution's cancer center. In this article, I reflect on my experiences during fellowship, and how I continue to derive satisfaction and joy from teaching palliative care to different levels of learners and through the meaningful connections I form with patients and their loved ones.

Short report: Gendered workplace social interaction processes in autism.

BACKGROUND: Navigating workplace social interactions can be stressful for autistic people and be experienced differently by gender. A better understanding of the autistic experience of these difficulties is needed to inform effective policy, practice, and individualized support. METHOD: Fifty-five autistic individuals (n women=32; n men=22) participated in either an online survey or focus group. Data were analyzed using inductive thematic analysis. RESULTS: The data suggests that the social and interaction expectations placed upon autistic individuals differ by gender and can contribute to occupational stress. CONCLUSIONS: The data provides a basis for further investigation considering Conservation of Resources Theory and its practical application to inform reasonable adjustments in the workplace for autistic people. WHAT THIS PAPER ADDS: The gendered workplace experiences of autistic people is an emerging area of research. However, how workplace social interactions are experienced by each gender remains under-researched. An understanding of this could help decrease occupational stress, inform reasonable adjustments, and increase labor market participation in this population. This paper adds to the existing literature in showing that workplace social interactions for autistic people are experienced differently by gender. As such, the implications in the experience of occupational stress may also differ. Therefore, the importance of having reasonable adjustments in the workplace that account for gender is highlighted.

Gender does not make the difference: interest in STEM by gender is fully mediated by technical socialization and degree program.

In Germany, there is a shortage of skilled workers in the fields of science, technology, engineering, and mathematics (STEM) and especially in technology with declining interest in technology and with supposedly fewer teachers in technology education in the next 20 years. The present study examined whether students' interest in STEM is dependent on their career choices (i.e., their degree program), their technical socialization, their personality, and gender. A survey in Germany, Baden-Wuerttemberg (N = 350) examined gender-specific differences in teacher training students with and without technology and engineering students via structural equation modelling with the mediators personality, technical socialization, and degree program. Results show that interest in STEM by gender is fully mediated by technical socialization and degree program. Solutions for the reduction of the staff shortage and gender gap in the technical domain are discussed and it is suggested that an integration of technology lessons in the school curriculum and a reduction of gender normatives may help.