The toxic continuum from incivility to violence: What can HRD do

Abstract The frequency, intensity, and duration of uncivil behavior should be a concern to leaders in any organization. All too often seemingly isolated, subtle uncivil incidents (e.g., instigating a joke) can lead to patterns of uncivil behavior (e.g., bullying) and even physical violence. Each is a form of aggressive behavior. Inasmuch as uncivil behavior is linked to poorer individual-(e.g., job performance) and organizational-level (e.g., costs) outcomes, human resource development (HRD) is increasingly being called to implement useful strategies for dealing effectively with this vital workplace issue. The article traces the more subtle forms of uncivil behavior that tend to be ambiguous in intent to more intentional forms of uncivil behavior, that is, bullying and physical violence. The article suggests that HRD can make a strong, positive contribution to reducing the likelihood of uncivil behaviors, which in turn can play a meaningful role in increasing the success of the organization. Finally, a summary of the eight articles are presented that comprise this issue

Risk-taking attitudes and their association with process and outcomes of cardiac care: a cohort study

<p>Abstract</p> <p>Background</p> <p>Prior research reveals that processes and outcomes of cardiac care differ across sociodemographic strata. One potential contributing factor to such differences is the personality traits of individuals within these strata. We examined the association between risk-taking attitudes and cardiac patients' clinical and demographic characteristics, the likelihood of undergoing invasive cardiac procedures and survival.</p> <p>Methods</p> <p>We studied a large inception cohort of patients who underwent cardiac catheterization between July 1998 and December 2001. Detailed clinical and demographic data were collected at time of cardiac catheterization and through a mailed survey one year post-catheterization. The survey included three general risk attitude items from the Jackson Personality Inventory. Patients' (n = 6294) attitudes toward risk were categorized as risk-prone versus non-risk-prone and were assessed for associations with baseline clinical and demographic characteristics, treatment received (i.e., medical therapy, coronary artery bypass graft (CABG) surgery, percutaneous coronary intervention (PCI)), and survival (to December 2005).</p> <p>Results</p> <p>2827 patients (45%) were categorized as risk-prone. Having risk-prone attitudes was associated with younger age (p < .001), male sex (p < .001), current smoking (p < .001) and higher household income (p < .001). Risk-prone patients were more likely to have CABG surgery in unadjusted (Odds Ratio [OR] = 1.21; 95% CI 1.08–1.36) and adjusted (OR = 1.18; 95% CI 1.02–1.36) models, but were no more likely to have PCI or any revascularization. Having risk-prone attitudes was associated with better survival in an unadjusted survival analysis (Hazard Ratio [HR] = 0.78 (95% CI 0.66–0.93), but not in a risk-adjusted analysis (HR = 0.92, 95% CI 0.77–1.10).</p> <p>Conclusion</p> <p>These exploratory findings suggest that patient attitudes toward risk taking may <b>contribute to </b>some of the documented differences in use of invasive cardiac procedures. An awareness of these associations could help healthcare providers as they counsel patients regarding cardiac care decisions.</p