Negative partisanship is real, measurable, and affects political behaviour

Many people explain their political involvement with reference to the kinds of outcomes they’d like to avoid, with Republicans and Democrats alike often framing their campaigns around ‘keeping out’ the opposite side. But what do we actually know about what Nicholas J. Caruana calls ‘negative partisanship’? He presents evidence from Canada that shows it explains a great deal about political involvement, and that there are lessons for political engagement more widely

Should Voters Decide? Exploring Successes, Failures and Effects of Electoral Reform

Are Citizens’ Assemblies useful tools for reforming democratic institutions and addressing the democratic deficit? Evaluating the utility of using mini-publics to deliberate issues like electoral reform based only on their record of success does not recommend this approach. But this sort of assessment is weakened by a lacuna in the study of Citizens’ Assemblies: we do not know whether such deliberative bodies, thanks to their inherent high levels of democratic participation, might have added democracy-enhancing value over and above traditional elite-centric reforms. This dissertation establishes a theoretical model for evaluating whether a particular path to electoral reform has independent effects on the quality of democracy and on the democratic deficit, regardless of whether the proposed change is implemented. Elite-centric and more deliberative processes are evaluated based on their input and output legitimacy (Scharpf 1997, 1999) to determine whether high-input-legitimacy processes, such as Citizens’ Assemblies or similar efforts, have a positive effect on the quality of democracy, even in the absence of changed electoral laws. Twelve case studies at the national and subnational levels within the last thirty years are evaluated using a detailed and deeply historical treatment to determine whether the enhanced input legitimacy of a deliberative process has independent effects that make the Citizens’ Assembly template worth using to tackle the democratic deficit. The overall conclusion of the study is that Citizens’ Assemblies can fail to have an independent effect on the quality of democracy if the process is abandoned or subverted by elites, and proposed reforms require elite support through to the end in order to have a positive effect. Therefore, Citizens’ Assemblies can be worthwhile as tools to reform democracy if they receive proper elite support from start to finish

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Negative Partisanship in a Multi-party System: The Case of Canada

<div><p></p><p>The origins and implications of partisan identification are well studied, but negative partisan attitudes – dislike for a particular party – have escaped such scrutiny. We argue that the concept of partisanship, especially in a multi-party system, is incomplete until negative sentiments are considered. In this paper, we refine the concept of negative partisanship (NPID) by providing an improved method of operationalizing it, examine its incidence and relationship with positive party identification in a multi-party system, and propose two theories of its origins. Our results, based upon data from five Canadian federal elections, indicate that studying NPID in a multi-party system requires a broader understanding of the mechanisms that lead to negative party attitudes than in a two-party system.</p></div

Intact prioritisation of unconscious face processing in schizophrenia

Introduction: Faces provide a rich source of social information, crucial for the successful navigation of daily social interactions. People with schizophrenia suffer a wide range of social-cognitive deficits, including abnormalities in face perception. However, to date, studies of face perception in schizophrenia have primarily employed tasks that require patients to make judgements about the faces. It is, thus, unclear whether the reported deficits reflect an impairment in encoding visual face information, or biased social-cognitive evaluative processes. Methods: We assess the integrity of early unconscious face processing in 21 out-patients diagnosed with Schizophrenia or Schizoaffective Disorder (15M/6F) and 21 healthy controls (14M/7F). In order to control for any direct influence of higher order cognitive processes, we use a behavioural paradigm known as breaking continuous flash suppression (b-CFS), where participants simply respond to the presence and location of a face. In healthy adults, this method has previously been used to show that upright faces gain rapid and privileged access to conscious awareness over inverted faces and other inanimate objects. Results: Here, we report similar effects in patients, suggesting that the early unconscious stages of face processing are intact in schizophrenia. Conclusion: Our data indicate that face processing deficits reported in the literature must manifest at a conscious stage of processing, where the influence of mentalizing or attribution biases might play a role

Isometric Handgrip Exercise: Does Device Matter?

Hypertension (HTN), or high blood pressure (BP), is the leading cause of cardiovascular disease-related death and disability worldwide (1). Deemed a global epidemic by the World Health Organization (2-6), HTN is the most commonly diagnosed chronic condition in primary care (7-9). BP control is inadequate world-wide, with more than half of patients not treated to within clinical target ranges (10). Thus, there is an urgent need to implement effective therapies that adequately lower and maintain BP. Newly incorporated into the American College of Cardiology/American Heart Association Guidelines for the Prevention and Management of High Blood Pressure (11), isometric handgrip (IHG) training is one such therapy (four, 2-min sustained squeezes at 30% of maximal effort, separated by 1-min rest, performed 3X/week on a computerized handgrip dynamometer). The high costs associated with the computerized devices (upwards of ~$400 CAD) may impede the main stream utilization of IHG training for BP management. As a first step in determining the effectiveness of an inexpensive (mechanical, ~$10 CAD) device to lower BP, this study compared systolic and diastolic BP responses to an acute bout of IHG performed using the mechanical and computerized devices. Young, healthy adults (N=12; 5 women; resting BP: 114/65 mmHg) randomly performed a bout of IHG on each device, with a 30-minute resting period between protocols. BP was acquired every minute using the Dinamap ProCare 200 BP Monitor. Across all contractions, the peak systolic BP response was similar between devices (all P \u3e 0.05). With the exception of the 2nd contraction eliciting a higher BP response in the mechanical device (P = 0.013), diastolic BP changes were also similar (all P \u3e 0.05). These findings suggest that more affordable devices may be an acceptable, low-cost alternative to the computerized IHG device, and that groundwork has been laid for a future training study. 1. Pan American Health Organization/World Health Organization. (2013). World health day: In the Americas, one in three adults has hypertension, the leading risk factor for death from cardiovascular disease. Retrieved from: http://www.paho.org/hq/index.php?option=com_content&view=article&id=8466&Itemid=1926&lang=en 2. World Health Organization. (2013). A global brief on hypertension: Silent killer, global public health crisis. Retrieved from: http://apps.who.int/iris/bitstream/10665/79059/1/WHO_DCO_WHD_2013.2_eng.pdf?ua=1 3. Joffres, M., Falaschetti, E., Gillespie, C., Robitaille, C., Loustalot, F., Poulter, N., … Campbell, N. (2013). Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: A cross-sectional study. British Medical Journal, 3(8). doi:10.1136/bmjopen-2013-003423. 4. Danaei, G., Ding, E., Mozaffarian, D., Taylor, B., Rehm, J., Murray, C., & Ezzati, M. (2011). The preventable causes of death in the United States: Comparative risk assessment of dietary, lifestyle, and metabolic risk factors. Public Library of Science Medicine, 8(1). doi:10.1371/annotation/0ef47acd-9dcc-4296-a897-872d182cde57. 5. Benjamin, E., Blaha, M., Chiuve, S., Cushman, M., Das, S., Deo, R., … Muntner, P. (2017). Heart disease and stroke statistics – 2017 update: A report from the American Heart Association. Circulation, 135(10). doi: 10.1161/CIR.0000000000000485. 6. Ezzati, M., Lopez, A., Rodgers, A., Vander Hoorn, S., & Murray, C. (2002). Selected major risk factors and global and regional burden of disease. The Lancet, 360(9343). doi:10.1016/S0140-6736(02)11403-6. 7. Hemmelgarn, B., Chen, G., Walker, R., McAlister, F., Quan, H., Tu, K., … Campbell, N. (2008). Trends in antihypertensive drug prescriptions and physician visits in Canada between 1996 and 2006. The Canadian Journal of Cardiology, 24(6). 8. James, P., Oparil, S., Cushman, W., Dennison-Himmelfarb, C., Handler, J., Lackland, D., … Ortiz, E. (2014). 2014 Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). The Journal of the American Medical Association, 311(5). doi:10.1001/jama.2013.284427. 9. Centers for Disease Control and Prevention. (2017). National ambulatory medical care survey: 2013 State and national summary tables. Retrieved from: https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2013_namcs_web_tables.pdf 10. Go, A., Bauman, M., Coleman King, S., Fonarow, G., Lawrence, W., Williams, K., & Sanchez, E. (2014). An effective approach to high blood pressure control: A science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension, 63. doi:org/10.1161/HYP.0000000000000003. 11. Whelton, P., Carey, R., Aronow, W., Casey, D., Collins, K., Dennison Himmelfarb, C., … Wright, J. (2017). 2017 Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Journal of the American College of Cardiology. doi:10.1016/j.jacc.2017.07.745