Neuroethics in the Era of Teleneurology

The accelerating integration of telehealth technologies in neurology practice has transformed traditional interactions between neurologists and patients, allied clinicians and society. Despite the immense promise of these technologies to improve systems of neurological care, the infusion of telehealth technologies into neurology practice introduces a host of unique ethical challenges. Proactive consideration of the ethical dimensions of teleneurology and of the impact of these innovations on the field of neurology more generally can help to ensure responsible development and deployment across stages of implementation. Toward these ends, this article explores key ethical dimensions of teleneurology practice and policy, presents a normative framework for their consideration, and calls attention to underexplored questions ripe for further study at this evolving nexus of teleneurology and neuroethics. To promote successful and ethically resilient development of teleneurology across diverse contexts, clinicians, organizational leaders, and information technology specialists should work closely with neuroethicists with the common goal of identifying and rigorously assessing the trajectories and potential limits of teleneurology systems.

Development of a Conceptual Model of Occupational Stress for Athletic Directors in Sport Contexts

Previous studies have reported that occupational stress is a determinant risk factor for both chronic diseases and job performance among organizational leaders. Every occupation has its own culture and occupational climate influencing organizations within the industries. Thus, due to the idiosyncratic features inherent in sports, athletic directors may experience different occupational stressors. To date, there has been no comprehensive review of the occupational stress in athletic director contexts. Thus, based on the literature on both occupational stress and sport leadership, this study proposes a conceptual framework of occupational stress in sport leadership. The model identifies the five higher-order themes of occupational stressors and their associations with the first-level outcomes of individuals and the second-level outcomes of organizations. It also includes the two higher-order moderators of personal and organizational factors. It is hoped that this initiative can invoke interest in this topic to provide health-enhancing environments for athletic directors and quality sport services to society.

Improving Organizational Commitment to Diversity, Equity, Inclusion, and Belonging

This chapter aims to provide useful information about the implementation of diversity equity, inclusion, and belonging (DEIB) to improve organizational performance. This chapter provides a conceptual framework for organizational leaders who desire additional awareness and knowledge regarding the nature, extent, and impact of diverse employees' barriers. Further, the purpose of this endeavor is to demonstrate that the persistent lack of recruitment, promotion, and retention of diverse employees is due to systemic, structural, organizational, institutional, cultural, and societal obstacles. Further, the theory of generative interactions (TGI) supports how obstacles must be acknowledged and eliminated through increased awareness of the issues linked to evidence-based, data-driven approaches leading to measurable key process indicators (KPIs) and outcomes. To support DEIB initiatives, many organizations have developed the Chief Diversity Officer (CDO) position to manage the process, eliminate barriers, and proactively strengthen organizational culture.

Driving for the unique opportunity for work: a qualitative study of nurses' motivation to commute to work

PurposeThis study aims to investigate what motivates nurses who live in a rural region with many vacant positions to choose a longer commute to work in a more populous capital region.Design/methodology/approachA qualitative descriptive design was used for this study. Nineteen commuting nurses were recruited through purposeful and snowball sampling and interviewed over the telephone. The interviews were analyzed using a manifest and latent content analysis.FindingsThe findings showed how the participating nurses' motivations to work in the capital region far away from their home were grounded in reaching the unique opportunity for work as a part of the unique organizational conditions, the unique positions and the unique work environment. The analysis showed how the nurses believed in better possibilities for themselves regarding opportunities for careers, specialized positions, development and education, as well as a lower hierarchy in management.Research limitations/implicationsStudies of commuting among nurses are sparsely investigated in the literature and especially through the lens of motivation. The few existing studies report on cross-sectional data, and to the authors’ knowledge, no studies have been investigated using a qualitative design. For future research, it would therefore be relevant to investigate nurses' motivation to commute to work in other countries in a larger sample and perhaps with larger commuting distances. This could contribute to a broader and more nuanced understanding of the factors that motivate nurses to commute long distances to work, not just nationally but also internationally.Practical implicationsThe authors have conceptualized which factors most affect nurses' motivation to commute to work from a rural to more populous capital region in Figure 2. Here, the findings of the study are presented alongside the two theoretical perspectives used to frame the study. The figure can be used as a benchmark for organizational leaders who are interested in recruitment and retention of nurses, and in particular whether they are interested in the specific factors affecting nurses' motivation to commute to work. Based on the study findings, the authors suggest that rural hospital organizations can benefit from focusing on building their reputation and including what factors make them unique and desirable. However, this is a balancing act for organizational leaders, as they must deliver on promises made to nurses when they are engaged in recruitment. If they fail to do so, as indicated in the findings, nurses are likely to leave the organization for other job opportunities.Originality/valueThis study contributes to new knowledge on why nurses decide to commute to work from rural areas to more populated areas. Looking at the nurses' reasons and perspective for commuting, the authors must acknowledge the difficulties in retaining nurses in rural regions. From a recruitment and retention perspective, nurse employers in rural regions must increase their offerings of unique work opportunities, including maintaining competitive pay and offering career, development and educational opportunities.

A Systematized Approach to Advancing the Quality of Community-Based Palliative Care

Despite growing recognition of the importance of community-based palliative care, optimizing the use of services continues to be a challenge. Until recently, key barriers were reimbursement and limited access. As services have become increasingly available, engagement of patients and their caregivers has emerged as a major obstacle. The Palliative Activation SystemTM (PAS) is a comprehensive, quality improvement methodology designed to promote enhanced engagement of seriously ill adults and their caregivers in optimizing the use of community-based palliative care services and accelerate clinicians’ progress in meeting patients’ and caregivers’ care goals. This paper describes the design of the PAS. Experts in patient engagement and the development and evaluation of palliative care programs advised organizational leaders in the development of this methodology. The “Patient and Family Engagement” framework proposed by Carman and colleagues (2013) guided this work. The framework informed the selection of three core concepts—care alignment, illness trajectory, and social determinants of health—as foundational to the goals of the PAS. Additionally, this framework guided the selection of measures that will be used to assess progress in achieving enhanced engagement. This background work, coupled with findings from interviews with patients and caregivers who are current recipients of palliative care services, resulted in the implementation and ongoing testing of strategies targeting clinicians and organizational leaders and designed to enhance engagement. Lessons learned from the design phase of the PAS will advance the efforts of other organizations committed to increasing patient and caregiver engagement and enhancing attainment of their goals.

How preferences for types of appreciation differ across employee age groups

Purpose Organizational leaders and human resource professionals affirm that to have (and keep) an effective workforce, understanding one’s employees is critical. Thus, understanding the differences between employees of different age groups is important. Simultaneously, studies have demonstrated the significant positive impact appreciation has on the functioning of organizations. When team members feel truly valued, numerous positive benefits result, including lower staff turnover, less absenteeism, higher customer ratings and greater profitability. Design/methodology/approach Because individuals prefer to be shown appreciation in different ways and prior research has shown some age differences, this study examined how appreciation preferences differ across seven employee age groups. Over 190,000 individuals completed an online assessment based on the five languages of appreciation, which identifies employees’ preferred ways of receiving appreciation. The respondents were separated into seven age groups, from 19 years old and younger to 70 years old and above. Findings The results of an analysis of variance found that there were significant differences across groups. Although the patterns of preferences were largely the same across many groups, post hoc analyses found both the youngest and oldest age groups differed from employees in their 30s with regards to their desire for quality time. Additionally, older employees were extremely low in their desire for tangible gifts. Originality/value As the proportion of employees shifts from older to younger groups of employees, these results raise important implications for organizations’ approaches regarding how appreciation and other motivators should be adjusted for different groups of employees.

So tired, I can't even help you: how work-related sleep deprivation evokes dehumanization of organizational leaders and less organizational citizenship behavior

To unpack the relationship between employees' work-induced sleep deprivation and their organizational citizenship behavior, this study details a mediating role of their propensities to dehumanize their organizational leaders, as well as a moderating role of perceived job formalization. Survey data collected from employees who work in the oil distribution sector show that a critical reason that persistent sleep problems, caused by work, reduce the likelihood that they engage in voluntary work efforts is that they treat organizational leaders as impersonal objects. Perceptions of the presence of job formalization or red tape invigorate this detrimental effect. For organizational practitioners, this study accordingly reveals a notable danger for employees who have trouble sleeping due to work: They do not take on extra work that otherwise could add to their organizational standing. This counterproductive dynamic is particularly salient when employees believe that their work functioning is constrained by strict organizational policies and guidelines.

Revisiting Leadership Communication: A Need for Conversation

Effective communication is critical for leaders to influence and create an impact within and outside organizations. Despite this, questions are raised regarding the efficacy & effectiveness of organizational leaders in conducting meaningful communication & conversations with their teams. Often, organizations are unsure of the specific leadership communication attributes and their outcomes at the individual, team and organizational levels. The primary objective of this study is to evaluate the impact of leaders’ communication on the feelings and thoughts of subordinates and to identify attributes for a possible measure of ‘effective leadership communication’. On the basis of ‘communicative leadership’ theorization by Johansson et al. (2014) , primary data was collected from employees’ across organizations. The study reveals gaps in the leader’s communication competence and suggests a need for more meaningful conversation with subordinates. The study proposes a tool for leadership communication assessment comprising two factors: transforming thoughts and transforming individuals.

Supporting the Sharing of Mental Health Challenges in the Workplace: Findings from Comparative Case Study Research at Two Mental Health Services

Personal experience with mental health (MH) challenges has been characterized as a concealable stigma. Identity management literature suggests actively concealing a stigma may negatively impact wellbeing. Reviews of workplace identity management literature have linked safety in revealing a stigma to individual performance, well-being, engagement and teamwork. However, no research to date has articulated the factors that make sharing MH challenges possible. This study employed a comparative case study design to explore the sharing of MH challenges in two Australian MH services. We conducted qualitative analyses of interviews with staff in direct service delivery and supervisory roles, to determine factors supporting safety to share. Workplace factors supporting safety to share MH challenges included: planned and unplanned “check-ins;” mutual sharing and support from colleagues and supervisors; opportunities for individual and team reflection; responses to and management of personal leave and requests for accommodation; and messaging and action from senior organizational leaders supporting the value of workforce diversity. Research involving staff with experience of MH challenges provides valuable insights into how we can better support MH staff across the workforce.