Ethnicity and organisational politics: Making sense of the game and learning its rules

Black Asian and Minority Ethnic (BAME) employees are underrepresented in senior roles. One possible reason for this is that the informal or political side of organisations might be difficult to navigate for these individuals because they are ‘left out of the loop’ when it comes to learning about workplace politics. In this research, I examined how BAME employees learn about and make sense of workplace politics

Ethnicity and Differential Career Success

Despite evidence that the representation of minority-ethnic employees in the workforce is improving, many are concentrated at lower organisational levels and experience more difficulties reaching senior positions than their majority-ethnic (i.e. white) colleagues (ONS, 2011). The percentage of minority-ethnic individuals entering the workplace is continually rising (ONS, 2011) meaning differential career success is a topic of increasing importance. However, thus far, very little research in organisational psychology has focused on ethnicity (Cox, Nkomo & Welch, 2001; Kenny & Briner, 2007). Therefore this thesis presents three studies designed to enhance our knowledge of minority-ethnic career experiences and the processes that contribute towards differential career success. All studies took place in a large U.K. public sector organisation. The first study compared the causal attributions that minority-ethnic (n=20) and majority-ethnic (n=20) managers made when recalling significant positive and negative career experiences during semi-structured interviews. In the second study, template analysis was used to examine the interview transcripts for career experiences identified as important for career success by minority- and majority-ethnic managers. An important difference between the groups was their perceptions of informal organisational processes. Researchers have argued that political skill may enhance individuals’ power and control over informal processes (e.g. Ferris, Davidson & Perrewé, 2005) and have also suggested, but not yet tested, that minority groups may be disadvantaged in developing these skills (Ferris, Frink & Galang, 1993). Therefore, study three built on the findings of study two, and tested the ‘political skill deficiency’ hypothesis, by determining whether minority-ethnic employees (n=114) rated themselves lower on political skill than majority-ethnic employees (n=197), and whether this was associated with differential career success. Overall findings suggested that there were important differences in the way minority- and majority-ethnic managers made sense of their career experiences. Minority-ethnic employees’ lower ratings of political skill were also associated with differential career success. Implications of these findings and practical initiatives to address differential career success are discussed in the final chapter, as well as directions for future research

A Bridge over Troubled Borders: Social Class and the Interplay between Work and Life

Drawing on border theory, this article presents a study of the role that social class plays in the interplay between work and non-work life. A survey was used to collect subjective ratings of social class for class origin, home and work domains. Interviews were then conducted with 20 individuals to explore participants’ experiences of social class across their work-life domains. The analysis identified five groups of individuals who experienced different work-life outcomes depending on their self-perceived social class and any experiences of social class travel. The study found that socially mobile interviewees had more complex work-life experiences and found work-life interplay more challenging than those whose social class was congruent across domains, challenging the assumption that social mobility is inherently beneficial. The article proposes that social class acts as a bridge, which either facilitates or impedes the ease with which individuals move between their work-life domains

Party people: differentiating the associations of partisan identification and partisan narcissism with political skill, integrity, and party dedication

AbstractWe investigated outcomes associated with different types of partisan identity in a sample of political candidates for parliament and local offices (N = 214). We distinguished partisan narcissism, a belief in the greatness of one's political party that is not appreciated by others, from partisan identification, feeling part of the party and evaluating it positively. We examined their links with self‐reported measures of politicians' functioning in their work: political skill, integrity, and party dedication. Partisan narcissism was associated with lower integrity in one's political role, meaning those high in partisan narcissism reported more inclination to engage in secrecy, deception, and political blood‐sport (behavior also known as politicking). Partisan narcissism did not predict party dedication: it was not associated with intentions to leave the party and volunteering in party activities, and in fact, it was linked to past membership in other political parties. Meanwhile, we found that partisan identification was associated with higher levels of political skill, while also predicting party dedication in that it predicted lower intentions to leave the party and volunteering in party activities but was unrelated to membership in other parties in the past. Cumulatively, these results suggest that partisan identification is associated with competence and dedication in politicians' work. Conversely, partisan narcissism seems to contribute to being cunning in the political arena and relates to more devious work habits that many find stereotypical of politicians

The prevention and treatment of glucocorticoid-induced osteopaenia in juvenile rheumatic disease : a randomised double-blind controlled trial

Background: Children and young people (CYP) with chronic rheumatic conditions; Juvenile Idiopathic Arthritis, Juvenile Systemic Lupus Erythematosus, Juvenile Dermatomyositis and Juvenile Vasculitis, treated with steroids, have low bone density, increased fracture risk and are likely to have suboptimal peak bone mass. There is currently no evidence base for the management of steroid-induced bone loss in children with rheumatic diseases. Methods: We undertook a multi-centre double dummy double-blind randomised placebo controlled trial to investigate whether the bisphosphonate risedronate was superior to alfacalcidol or calcium and vitamin D supplementation in the prevention and treatment of steroid-induced osteopaenia in these children. Patients were stratified and randomised in a 1:1 ratio, into: placebo; alfacalcidol; risedronate. The primary outcome was the change in lumbar spine bone mineral density z score (LSaBMDz) measured by dual energy x-ray absorptiometry at one year. Secondary outcome was fracture rate. Results: Two hundred and seventeen patients were recruited to the study. Seventy seven placebo, 71 alfacalcidol, and 69 risedronate. Highly statistically significant differences were observed in the change in LSaBMDz between the placebo and risedronate groups; 0.274, 95% CI (0.061, 0.487) (p < 0.001) and between the risedronate and the alfacalcidol groups; 0.326 95% CI (0.109, 0.543) (p < 0.001). The difference observed between the alfacalcidol and placebo group was not statistically significant. Highly statistically significant differences were seen in the change in Total Body Less Head aBMD-Z Score between the placebo and risedronate groups (p < 0.01) but not between the alfacalcidol and risedronate groups. No significant differences in fracture frequency, adverse or serious adverse reactions were observed between the groups. Conclusions: Children and adolescents receiving steroids for rheumatic diseases benefit from prophylactic treatment with bisphosphonates to increase LSaBMD. Alfacalcidol is ineffective

Mortality Among Adults With Cancer Undergoing Chemotherapy or Immunotherapy and Infected With COVID-19

Importance: Large cohorts of patients with active cancers and COVID-19 infection are needed to provide evidence of the association of recent cancer treatment and cancer type with COVID-19 mortality. // Objective: To evaluate whether systemic anticancer treatments (SACTs), tumor subtypes, patient demographic characteristics (age and sex), and comorbidities are associated with COVID-19 mortality. // Design, Setting, and Participants: The UK Coronavirus Cancer Monitoring Project (UKCCMP) is a prospective cohort study conducted at 69 UK cancer hospitals among adult patients (≥18 years) with an active cancer and a clinical diagnosis of COVID-19. Patients registered from March 18 to August 1, 2020, were included in this analysis. // Exposures: SACT, tumor subtype, patient demographic characteristics (eg, age, sex, body mass index, race and ethnicity, smoking history), and comorbidities were investigated. // Main Outcomes and Measures: The primary end point was all-cause mortality within the primary hospitalization. // Results: Overall, 2515 of 2786 patients registered during the study period were included; 1464 (58%) were men; and the median (IQR) age was 72 (62-80) years. The mortality rate was 38% (966 patients). The data suggest an association between higher mortality in patients with hematological malignant neoplasms irrespective of recent SACT, particularly in those with acute leukemias or myelodysplastic syndrome (OR, 2.16; 95% CI, 1.30-3.60) and myeloma or plasmacytoma (OR, 1.53; 95% CI, 1.04-2.26). Lung cancer was also significantly associated with higher COVID-19–related mortality (OR, 1.58; 95% CI, 1.11-2.25). No association between higher mortality and receiving chemotherapy in the 4 weeks before COVID-19 diagnosis was observed after correcting for the crucial confounders of age, sex, and comorbidities. An association between lower mortality and receiving immunotherapy in the 4 weeks before COVID-19 diagnosis was observed (immunotherapy vs no cancer therapy: OR, 0.52; 95% CI, 0.31-0.86). // Conclusions and Relevance: The findings of this study of patients with active cancer suggest that recent SACT is not associated with inferior outcomes from COVID-19 infection. This has relevance for the care of patients with cancer requiring treatment, particularly in countries experiencing an increase in COVID-19 case numbers. Important differences in outcomes among patients with hematological and lung cancers were observed

Do voters get it right? A test of the ascription-actuality trait theory of leadership with political elites

Are the traits preferred by voters also associated with success in political office? Drawing on the ascription-actuality trait theory of leadership the present study examines whether traits ascribed to politicians predict leadership outcomes differently to the actual traits they possess. We collected self-ratings of politicians’ personality (N=138) using the NEO-PI-R (actual traits) and observer ratings of politicians’ facial appearance (ascribed traits) to examine their relationship with (a) leadership emergence, measured using share of vote in election, and (b) in-role leadership effectiveness, rated anonymously by political and local authority colleagues. Facial appearance predicted leadership emergence but not effectiveness. Personality had a more nuanced relationship with leadership outcomes. Conscientiousness predicted effectiveness but not emergence, and Agreeableness revealed a trait paradox, positively predicting emergence and negatively predicting effectiveness. These findings suggest a need to understand the contested nature of political leadership and qualities required for different aspects of political roles

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Adding 6 months of androgen deprivation therapy to postoperative radiotherapy for prostate cancer: a comparison of short-course versus no androgen deprivation therapy in the RADICALS-HD randomised controlled trial

Background Previous evidence indicates that adjuvant, short-course androgen deprivation therapy (ADT) improves metastasis-free survival when given with primary radiotherapy for intermediate-risk and high-risk localised prostate cancer. However, the value of ADT with postoperative radiotherapy after radical prostatectomy is unclear. Methods RADICALS-HD was an international randomised controlled trial to test the efficacy of ADT used in combination with postoperative radiotherapy for prostate cancer. Key eligibility criteria were indication for radiotherapy after radical prostatectomy for prostate cancer, prostate-specific antigen less than 5 ng/mL, absence of metastatic disease, and written consent. Participants were randomly assigned (1:1) to radiotherapy alone (no ADT) or radiotherapy with 6 months of ADT (short-course ADT), using monthly subcutaneous gonadotropin-releasing hormone analogue injections, daily oral bicalutamide monotherapy 150 mg, or monthly subcutaneous degarelix. Randomisation was done centrally through minimisation with a random element, stratified by Gleason score, positive margins, radiotherapy timing, planned radiotherapy schedule, and planned type of ADT, in a computerised system. The allocated treatment was not masked. The primary outcome measure was metastasis-free survival, defined as distant metastasis arising from prostate cancer or death from any cause. Standard survival analysis methods were used, accounting for randomisation stratification factors. The trial had 80% power with two-sided α of 5% to detect an absolute increase in 10-year metastasis-free survival from 80% to 86% (hazard ratio [HR] 0·67). Analyses followed the intention-to-treat principle. The trial is registered with the ISRCTN registry, ISRCTN40814031, and ClinicalTrials.gov, NCT00541047. Findings Between Nov 22, 2007, and June 29, 2015, 1480 patients (median age 66 years [IQR 61–69]) were randomly assigned to receive no ADT (n=737) or short-course ADT (n=743) in addition to postoperative radiotherapy at 121 centres in Canada, Denmark, Ireland, and the UK. With a median follow-up of 9·0 years (IQR 7·1–10·1), metastasis-free survival events were reported for 268 participants (142 in the no ADT group and 126 in the short-course ADT group; HR 0·886 [95% CI 0·688–1·140], p=0·35). 10-year metastasis-free survival was 79·2% (95% CI 75·4–82·5) in the no ADT group and 80·4% (76·6–83·6) in the short-course ADT group. Toxicity of grade 3 or higher was reported for 121 (17%) of 737 participants in the no ADT group and 100 (14%) of 743 in the short-course ADT group (p=0·15), with no treatment-related deaths. Interpretation Metastatic disease is uncommon following postoperative bed radiotherapy after radical prostatectomy. Adding 6 months of ADT to this radiotherapy did not improve metastasis-free survival compared with no ADT. These findings do not support the use of short-course ADT with postoperative radiotherapy in this patient population