Intersectional Escape: Older Women Elude Agentic Prescriptions More Than Older Men.

Both older individuals and women are proscribed from engaging in power-related behaviors, with women proscribed from behaving agentically and older individuals expected to cede desirable resources through "Succession." However, little is known about whether these overlapping agency prescriptions equally target men and women across the lifespan. In seven studies, we find that older men face the strongest prescriptions to behave less agentically and cede resources, whereas older women are comparatively spared. We show that agency prescriptions more strongly target older men, compared to older women (Studies 1a, 1b, 2) and their younger counterparts (Studies 3 and 4) and examine social and economic consequences for agentic behavior in political, economic, and academic domains. We also find that older men garner more extreme (i.e., polarized) reactions due to their greater perceived resource threat (Studies 4-6). We conclude by discussing theoretical implications for diversity research and practical considerations for accommodating the fast-aging population.

Maximizing the Gains and Minimizing the Pains of Diversity: A Policy Perspective.

Empirical evidence reveals that diversity-heterogeneity in race, culture, gender, etc.-has material benefits for organizations, communities, and nations. However, because diversity can also incite detrimental forms of conflict and resentment, its benefits are not always realized. Drawing on research from multiple disciplines, this article offers recommendations for how best to harness the benefits of diversity. First, we highlight how two forms of diversity-the diversity present in groups, communities, and nations, and the diversity acquired by individuals through their personal experiences (e.g., living abroad)-enable effective decision making, innovation, and economic growth by promoting deeper information processing and complex thinking. Second, we identify methods to remove barriers that limit the amount of diversity and opportunity in organizations. Third, we describe practices, including inclusive multiculturalism and perspective taking, that can help manage diversity without engendering resistance. Finally, we propose a number of policies that can maximize the gains and minimize the pains of diversity.

Hair penalties: the negative influence of Afrocentric hair on ratings of Black women's dominance and professionalism.

PURPOSE: Women are penalized if they do not behave in a stereotype-congruent manner (Heilman, 1983, 2001; Eagly and Carli, 2007). For example, because women are not expected to be agentic they incur an "agency penalty" for expressing anger, dominance or assertiveness (Rudman, 1998; Rudman and Glick, 1999, 2001; Eagly and Karau, 2002; Rudman and Fairchild, 2004; Brescoll and Uhlmann, 2008; Livingston et al., 2012). Yet, all women are not equally penalized (Livingston et al., 2012). We make a novel contribution by examining how both White and Black evaluators respond to displays of Black women's dominance, in this case, whether Black women choose to wear Afrocentric or Eurocentric hairstyles. DESIGN/METHODOLOGY/APPROACH: We conducted three experimental studies to examine the influence of target hairstyle and participant race on ratings of the target's professionalism (Studies 1, 2, and 3) and dominance (Study 2). Study 1 was an online experimental study with 200 participants (112 females, 87 males, 1 missing gender; 160 Whites, 19 Blacks, 11 Latinos, 7 Asian Americans and 3 who identify as "other"; M age = 35.5, SD = 11.4). Study 2 was an online experimental study with 510 participants (276 women, 234 males; 256 Blacks, 254 Whites; M age = 41.25 years, SD = 12.21). Study 3 was an online experimental study with 291 participants (141 Blacks, 150 Whites, M age = 47.5 years, SD = 11.66). FINDINGS: Black, as compared to White, evaluators gave higher agency penalties to Black employment candidates when they donned Afrocentric versus Eurocentric hair, rating them as more dominant and less professional. IMPLICATIONS: The present research illustrates the significance of considering both target and evaluator race when examining the influence of agency, and specifically dominance, on ratings of professionalism.

Gender profiling: a gendered race perspective on person-position fit.

The current research integrates perspectives on gendered race and person-position fit to introduce the concept of a gender profile. We propose that both the "gender" of a person's biological sex and the "gender" of a person's race (Asians are perceived as feminine and Blacks as masculine) help comprise an individual's gender profile-the overall femininity or masculinity associated with their demographic characteristics. We also propose that occupational positions have gender profiles. Finally, we argue that the overall gender profile of one's demographics, rather than just one's biological sex, determines one's fit and hirability for feminine or masculine occupational roles. The current five studies establish the gender profiles of different races and sexes, and then demonstrate that individuals with feminine-typed and masculine-typed gender profiles are selected for feminine and masculine positions, respectively. These studies provide new insights on who gets ahead in different environments.

Rethinking the Baseline in Diversity Research: Should We Be Explaining the Effects of Homogeneity?

It is often surprisingly difficult to make definitive scientific statements about the functional value of group diversity. We suggest that one clear pattern in the group diversity literature is the prevailing convention of interpreting outcomes as the effect of diversity alone. Although work in this arena typically compares diverse groups with homogeneous ones, we most often conceive of homogeneous groups as a baseline-a reference point from which we can understand how diversity has changed behavior or what type of response is "normal." In this article, we offer a new perspective through a focus on two propositions. The first proposition is that homogeneity has independent effects of its own-effects that, in some cases, are robust in comparison with the effects of diversity. The second proposition is that even though subjective responses in homogeneous groups are often treated as a neutral indicator of how people would ideally respond in a group setting, evidence suggests that these responses are often less objective or accurate than responses in diverse groups. Overall, we believe that diversity research may unwittingly reveal important insights regarding the effects of homogeneity.

Key articles and guidelines for the prevention of venous thromboembolism.

Venous thromboembolism (VTE) is an important medical problem that affects millions of patients each year. With appropriate prophylaxis, many of these thromboembolic events can be prevented. Although strong evidence supporting VTE prophylaxis spans several decades, several large American and global registries have documented very poor use of appropriate prophylaxis. Because of increasing regulatory requirements, hospitals nationwide are in the process of developing documentation of appropriate VTE prophylaxis programs for both surgical and medical patients. A wide range of clinicians must understand what constitutes appropriate VTE prophylaxis in various patient populations. With the existence of numerous pharmacologic agents, abundance of data from major clinical trials, and several nationally recognized clinical guidelines, compiling the needed reference material to make evidence-based decisions on appropriate VTE prophylaxis can be difficult for clinicians. Therefore, we provide a bibliography of key articles and guidelines related to the prevention of VTE in various patient groups. We hope this compilation will serve as a resource for pharmacists, physicians, nurses, residents, and students responsible for the care of patients who may be at risk for VTE.

Is the pain worth the gain? The advantages and liabilities of agreeing with socially distinct newcomers.

The impact of diversity on group functioning is multifaceted. Exploring the impact of having a newcomer join a group, the authors conducted a 2 (social similarity of newcomer to oldtimers; in-group or out-group) x 3 (opinion agreement: newcomer has no opinion ally, one opinion ally, or two opinion allies) interacting group experiment with four-person groups. Groups with out-group newcomers (i.e., diverse groups) reported less confidence in their performance and perceived their interactions as less effective, yet they performed better than groups with in-group newcomers (i.e., homogeneous groups). Moreover, performance gains were not due to newcomers bringing new ideas to the group discussion. Instead, the results demonstrate that the mere presence of socially distinct newcomers and the social concerns their presence stimulates among oldtimers motivates behavior that can convert affective pains into cognitive gains.

Considerations in using anticoagulant therapy in special patient populations.

PURPOSE: The role of genetic polymorphisms and genetic testing in guiding warfarin dosing is discussed, as are the selection and monitoring of anticoagulant therapy for obese patients, patients with severe renal impairment, and patients with heparin-induced thrombocytopenia (HIT); case studies are used to illustrate each topic. SUMMARY: Genetic polymorphisms influence metabolism of and sensitivity to warfarin. People with certain ethnic backgrounds have a greater likelihood of having genetic polymorphisms that reduce warfarin dosing requirements and increase the risk of bleeding. Genetic testing has the potential to improve patient safety; however, its cost is high, and genetic polymorphisms account for only part of interindividual variation in dosing requirements. For obese patients, dose capping of low molecular weight heparin is not warranted, and twice-daily enoxaparin is preferred over once-daily dosing. Anti-Xa monitoring is perhaps not necessary for patients weighing less than 190 kg (418 lb), but it may be useful to adjust dosing in heavier patients. In patients with severe renal impairment, bleeding during anticoagulant therapy may be attributed to the uremic state, excessive doses, or both. Dosage reduction and anti-Xa monitoring are recommended for patients with severe renal impairment. Treatment of patients with HIT should include discontinuation of heparin, temporary interruption of warfarin therapy, and initiation of a direct thrombin inhibitor. CONCLUSION: Safe and effective use of anticoagulant therapy may require consideration of genetics, obesity, renal impairment, or the potential for HIT; selecting anticoagulant therapy on the basis of these considerations can present a challenge.

Optimizing antithrombotic therapy in patients with non-ST-segment elevation acute coronary syndrome.

PURPOSE: Considerations in selecting antithrombotic and antiplatelet therapy for patients with non-ST-segment elevation (NSTE) acute coronary syndrome (ACS), including patients undergoing percutaneous coronary intervention (PCI), are discussed, and case studies are used to illustrate. SUMMARY: Patients with NSTE ACS for whom a conservative treatment strategy is selected should receive enoxaparin, fondaparinux, or unfractionated heparin (UFH) as anticoagulant therapy. In high-risk patients with NSTE ACS for whom an early invasive strategy is planned, enoxaparin and UFH are the agents with the highest level of evidence (evidence level A). Fondaparinux and bivalirudin can also be used, but they have a lower level of evidence (evidence level B). Since fondaparinux use in patients undergoing PCI has been associated with an increased risk for catheter-related thrombosis, the use of fondaparinux in PCI patients should be limited. The use of bivalirudin alone is as effective and has been associated with less bleeding than the use of UFH or enoxaparin plus a glycoprotein (GP) IIb/ IIIa inhibitor in patients with NSTE ACS who undergo PCI. No benefit has been shown from adding bivalirudin to a GP IIb/ IIIa inhibitor. The role of GP IIb/IIIa inhibitors in patients with NSTE ACS and elevated troponin levels who are undergoing PCI has been well established, even for patients receiving high-dose clopidogrel. Anti-platelet therapy with clopidogrel has been shown to reduce both acute and chronic events in patients with NSTE ACS, including patients undergoing PCI. A conventional 300-mg clopidogrel loading dose needs to be administered at least six hours before PCI to achieve an adequate antiplatelet effect. A 600-mg loading dose appears to shorten the time to achieve an adequate antiplatelet effect to about two hours. CONCLUSION: The choice of anticoagulant and antiplatelet agents, dose, and timing of administration can affect outcomes in patients with NSTE ACS.

Improving the use of anticoagulant therapies in acutely ill medical patients.

PURPOSE: Assessment of risk for the development of venous thromboembolism (VTE), selection of VTE prophylaxis in medical patients, strategies for improving prescribing practices to prevent VTE, and the impact of pharmacist-managed anticoagulation services are described; case studies are used to illustrate each topic. SUMMARY: Assessing risk for VTE is more complicated for acutely ill medical patients than for surgical patients. The risk of VTE in medical patients increases with the number of VTE risk factors the patient has. A number of regimens have demonstrated efficacy in reducing the rate of VTE in medically ill patients. Head-to-head studies suggest that enoxaparin 40 mg daily is at least as effective as unfractionated heparin (UFH) 5000 units three times daily for preventing VTE in acute medically ill patients. Because of greater efficacy, enoxaparin may be preferred over UFH in certain patient populations at particularly high risk for VTE. Although the efficacy of VTE prophylaxis is well documented, most patients at risk still do not receive this therapy. A combination of strategies is more effective than a single strategy for modifying prescribing practices to ensure that optimal VTE prophylaxis is provided when indicated. Pharmacist-managed anticoagulation services improve the appropriate use of anticoagulant agents, shorten hospital length of stay, and reduce mortality, drug-related complications, hospital readmissions for bleeding and thrombosis, and costs. CONCLUSION: Pharmacists can improve clinical and economic outcomes in acutely ill medical patients who are at risk for VTE through the use of various strategies, including anticoagulation management services.

The White standard: racial bias in leader categorization.

In 4 experiments, the authors investigated whether race is perceived to be part of the business leader prototype and, if so, whether it could explain differences in evaluations of White and non-White leaders. The first 2 studies revealed that "being White" is perceived to be an attribute of the business leader prototype, where participants assumed that business leaders more than nonleaders were White, and this inference occurred regardless of base rates about the organization's racial composition (Study 1), the racial composition of organizational roles, the business industry, and the types of racial minority groups in the organization (Study 2). The final 2 studies revealed that a leader categorization explanation could best account for differences in White and non-White leader evaluations, where White targets were evaluated as more effective leaders (Study 3) and as having more leadership potential (Study 4), but only when the leader had recently been given credit for organizational success, consistent with the prediction that leader prototypes are more likely to be used when they confirm and reinforce individualized information about a leader's performance. The results demonstrate a connection between leader race and leadership categorization.

Negational categorization and intergroup behavior.

Individuals define themselves, at times, as who they are (e.g., a psychologist) and, at other times, as who they are not (e.g., not an economist). Drawing on social identity, optimal distinctiveness, and balance theories, four studies examined the nature of negational identity relative to affirmational identity. One study explored the conditions that increase negational identification and found that activating the need for distinctiveness increased the accessibility of negational identities. Three additional studies revealed that negational categorization increased outgroup derogation relative to affirmational categorization and the authors argue that this effect is at least partially due to a focus on contrasting the self from the outgroup under negational categorization. Consistent with this argument, outgroup derogation following negational categorization was mitigated when connections to similar others were highlighted. By distinguishing negational identity from affirmational identity, a more complete picture of collective identity and intergroup behavior can start to emerge.

Outpatient management of oral vitamin K antagonist therapy: defining and measuring high-quality management.

Oral anticoagulation therapy with warfarin is the mainstay of prevention and treatment of thromboembolic disease. However, it remains one of the leading causes of harmful medication errors and medication-related adverse events. The beneficial outcomes of oral anticoagulation therapy are directly dependent upon the quality of dose and anticoagulation management, but the literature is not robust with regards to what constitutes such management. This review focuses on, and attempts to define, the parameters of high-quality anticoagulation management and identifies the appropriate outcome measures constituting high-quality management. Elements discussed include the most fundamental measure, time in therapeutic range, along with other parameters including therapy initiation, time to therapeutic range, dosing management when patients are not in therapeutic range, perioperative dosing management, patient education, and other important outcome measures. Healthcare providers who manage oral anticoagulation therapy should utilize these parameters as a measure of their performance in an effort to achieve high-quality anticoagulation management.

Survey of pharmacist-managed inpatient anticoagulation services.

PURPOSE: The scope of existing pharmacist-managed inpatient anticoagulation services and the roles and responsibilities of the pharmacists involved were studied. METHODS: A general query regarding the provision of inpatient anticoagulation services was sent by e-mail to members of the American College of Clinical Pharmacists practice and research networks for cardiology, critical care, and general internal medicine. Those individuals whose institutions had such services were sent a written questionnaire and asked to describe the scope of the services provided. Data collected included a description of the type of service model and the management strategies for seven different antithrombotic agents: warfarin, unfractionated heparin, low-molecular-weight heparin, fondaparinux, argatroban, lepirudin, and bivalirudin. Survey results were entered into a database and sent to all participants for use as a resource. RESULTS: Of the 33 respondents to the initial e-mail, 25 completed the written questionnaire. A variety of service models were used, most of which were developed and implemented within the past seven years. The majority of services (92%) were consultation based, many of which incorporated daily pharmacist rounds. Less than half of the services were under the supervision of a physician, and only four services involved a multidisciplinary team. In addition, the management of individual antithrombotic agents varied between services, including the automatic management of all patients receiving targeted agents, strict institution-specific protocols, and general guidelines. All but one service provided educational opportunities for students and residents. CONCLUSION: Inpatient anticoagulation services described by survey respondents varied in design, structure, and level of responsibility of pharmacists.

When what you know is not enough: expertise and gender dynamics in task groups.

This study investigates how the contribution, identification, and consideration of expertise within groups are affected by gender differences. The authors examined the effects of member expertise and gender on others' perceptions of expertise, actual and own perceptions of influence, and group performance on a decision-making task. The authors' findings are consistent with social role theory and expectation states theory. Women were less influential when they possessed expertise, and having expertise decreased how expert others perceived them to be. Conversely, having expertise was relatively positive for men. These differences were reflected in group performance, as groups with a female expert underperformed groups with a male expert. Thus, contrary to common expectations, possessing expertise did not ameliorate the gender effects often seen in workgroups. The findings are discussed in light of their implications for organizational workgroups in which contribution of expertise is critical to group performance.

The effects of categorically based expectations on minority influence: the importance of congruence.

The role of congruence and incongruence in diverse decision-making groups is examined by manipulating opinion agreement within and between members of different social categories. Congruence occurs when ingroup members agree with one another and outgroup members disagree, whereas incongruence occurs when an ingroup member disagrees with a majority composed of ingroup and outgroup members. The results of two studies, one using a scenario methodology and the second using simulated work teams with two ingroup members and one outgroup member, show that regardless of the task-relevance of salient differences, individuals respond most favorably when categorical and opinion differences are congruent. Study 1 examined individuals' emotional reactions and group efficacy. Study 2 examined group performance, the minority influence process, and efforts to maintain congruence. The findings suggest that outgroup minority opinion holders may be more influential in diverse group decision-making settings than ingroup minority opinion holders.