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Acute and chronic pain affects more Americans than heart disease, diabetes, and cancer combined. Conservative estimates suggest the total economic cost of pain in the United States is $600 billion, and more than half of this cost is due to lost productivity, such as absenteeism, presenteeism, and turnover. In addition, an escalating opioid epidemic in the United States and abroad spurred by a lack of safe and effective pain management has magnified challenges to address pain in the workforce, particularly the military. Thus, it is imperative to investigate the organizational antecedents and consequences of pain and prescription opioid misuse (POM). This chapter provides a brief introduction to pain processing and the biopsychosocial model of pain, emphasizing the relationship between stress, emotional well-being, and pain in the military workforce. We review personal and organizational risk and protective factors for pain, such as post-traumatic stress disorder, optimism, perceived organizational support, and job strain. Further, we discuss the potential adverse impact of pain on organizational outcomes, the rise of POM in military personnel, and risk factors for POM in civilian and military populations. Lastly, we propose potential organizational interventions to mitigate pain and provide the future directions for work, stress, and pain research.

Members of an organization facing change often struggle to adapt and may create new routines. Drawing on insights from a case study of bariatric robotic surgery, the authors illustrate how a new ecology of space transforms the ostensive and performative aspect of a routine during the introduction of a new technological artifact. The authors discuss two types of space: experimental and reflective. The authors show that the reflective space through debriefings enables practitioners to discuss the new patterns of interdependent actions. Practitioners explore the different aspects of the performative struggle with new artifacts and try to integrate new actions and delineate the boundaries of this change during experimental performances. The findings of this study throw light on the role of the reflective space in addition to the experimental space in routine change, and suggest that socio-material ensembles can produce opportunities for reshaping routines.

War is undoubtedly a dirty business, usually entailing massive destruction and loss of life on both sides. In an attempt to limit this inevitable death and destruction, philosophers have argued that belligerents must following certain principles in the conduct of warfare; namely, the principles of discrimination (that only legitimate military targets may be attacked) and of proportionality (that the damage done in attacking such targets must not be out of proportion to the military value of the target). These principles have come to be enshrined in International Law through a range of treaties, which are collectively known in military circles as the International Law of Armed Conflict (LOAC).

The essential idea at the heart of Michael Walzer’s supreme emergency argument, or as Brian Orend calls it, the supreme emergency exemption, is that desperate times call for desperate measures. If the situation is dire enough, and the consequences faced are serious enough, then it will be justifiable to act in ways which would normally be prohibited. In concrete terms, what this means is that during a time of war, a state can in some circumstances ignore the usual rules of warfare (i.e. the principles of discrimination and proportionality). Walzer claims this is justified if and only if the following conditions are met: the state is the victim of aggression, the state is about to be militarily defeated, and that the consequences of defeat will be catastrophic (i.e. would include extreme and widespread violations of fundamental human rights). In other words, when faced with a supreme emergency one is justified in engaging in widespread violations of the rights of some people (people to whom one only has a general duty) in order to prevent widespread violations of the rights of others (people to whom one has a specific duty).

In this paper I argue that the ‘rules’ which must be applied in order for widespread rights-violations to be considered justified are actually well understood, and that supreme emergency is not an unusual situation for which new rules must be considered, but simply an important specific example of such a situation. Essentially I argue that one must dirty one’s hands in war, but that there is no need for one’s hands to get any dirtier in a situation of supreme emergency.

This paper provides a novel framework for considering a much-debated question within military ethical fields, using insights from two of the major proponents of contemporary military ethics.

In this chapter, we overview different neuroenhancement techniques that could be applied for accelerating the learning process in a number of tasks that are associated with occupational roles. The techniques range from: (1) pharmaceutical and invasive methods with limited applicability to the healthy population, due to possible side effects and obtrusiveness; (2) game-based brain training that shows task-specific potential, but may not generalize; and (3) a promising new research direction in which the goal is to “train” the brain to reach an optimal cognitive state for performing a given task, and remain in this state by self-regulation. However, in order to accomplish this goal of brain training, the neurological markers that best discriminate good task performance need to be identified. We also review a number of initial studies in this chapter which have analyzed such markers in a variety of training-related applications for different occupations, such as military/security (e.g., marksmanship, deadly force judgment and decision making, submarine piloting and navigation, phishing detection), medicine (e.g., robot-assisted surgery), banking (e.g., financial traders), sports (e.g., golf, archery, and baseball), or entertainment (e.g., musicians and actors). The promising results of these early studies are fueling interest in neuroscience-based technology and methods in the rapidly developing field of organizational neuroscience (e.g., leadership research). We conclude the chapter with a discussion of future research directions.

Purpose: We respond to a call for studies of “embodied experiences of stigma in context” by investigating how transgender embodiment shapes perceived needs for access to and experiences of “sex-specific” cancer screenings (SSCS) (e.g., breast and prostate exams, Pap smears) in the North American healthcare system.

Design/Methodology/Approach: We analyze data from semistructured interviews with a diverse sample of 35 transgender-identified adults. Based on thematic narrative analysis, we explore four themes in relation to embodiment: discrimination; discomfort and hyperawareness of genitalia; strategic reframing and active management; and SSCS health care encounters as positive and gender affirming.

Findings: In relation to SSCS, transgender individuals experience discrimination, do emotion work, and actively manage situations to obtain needed health care, and sometimes forego care because barriers are insurmountable. Health care providers' responses to transgender embodiment can disrupt health care encounters, but they can also facilitate access and create opportunities for affirmation, agency, advocacy, and new forms of interaction. Embodiment- and gender-affirming interactions with health care providers, which varied by gender, emerged as key influences on participants' experiences of SSCS.

Research Limitations/Implications: Our sample primarily includes binary gender-identified individuals, and while our interview guide covered many topics, the SSCS question did not explicitly reference testicular exams.

Practical Implications: Cancer prevention and detection Cancer prevention and detection require health care professionals who are prepared for differently embodied persons. Preventive cancer screenings are not “sex-specific”; they are relevant to individuals with medically necessary needs regardless of gender identity or embodiment.

Social Implications

Originality/Value: Few medical sociologists have focused on transgender embodiment. Findings enhance our understanding of how transgender embodiment and minority stress processes influence access to needed SSCS.

This paper examines how cultural holes that exist at the intersection of institutional fields influence the exploitation of entrepreneurial opportunities. Through an exploration of physician-founded ambulatory surgery centers in the United States, we examine how the presence of cultural holes presented doctors with alternative beliefs, values, and practices to overcome the cultural constraints around entrepreneurship within the medical profession. In doing so, this study extends cultural entrepreneurship research by bringing cultural holes to the forefront, empirically showing how they facilitate entrepreneurial action and proposing other contexts where cultural holes may affect entrepreneurial actions and outcomes.

Systematic oppression and marginalization of queer (sometimes also referred to as LGBTQ) people has affected all aspects of U.S. society, including education at all levels. Despite the heavy policing of queer sexuality and gender both inside and outside higher education, these aspects of identity have been overlooked in educational policy. This paper discusses federal educational policy that affects queer students, faculty, and staff in higher education.

Discussion in this paper is informed by three guiding tenets: sexuality is both central and marginal to queer identities; trans* identities are both inclusive of and beyond those who are in the process of confirming their gender identity through hormones and/or surgery; discussion of educational policy must acknowledge queer theory’s utility and nonutility.

The status of queer people in colleges and universities is reviewed first. Then, challenges of developing policy to address queer issues are acknowledged, while also illustrating recent policy changes and judicial rulings that have positive implications for queer people in higher education.

The paper concludes by identifying remaining gaps and recommendations for future policy development, including the need for federal nondiscrimination laws that cover sexual and gender minorities and restructuring policies for queer inclusion.

Academic freedom is a complicated issue for military service academies. As accredited institutions of higher learning, academic freedom is valued. At the same time, the academies are subject to regulations that guide speech and publishing by the Department of Defense. This chapter explores the balance between maintaining academic freedom while upholding the discipline contained in regulations concerning free speech. The chapter concludes with a view to the future and opportunities for further research.