Trust in Government in the Trump Era: A Comprehensive Study of U.S. Public Opinion on the Federal Government Under the Trump Administration

The election and presidency of Donald Trump has upended American politics in numerous ways. For his most ardent supporters, President Trump's efforts to change things in Washington; to deliver nationalist economic policies on trade, jobs, and immigration; and to advance culturally conservative rhetoric and racial appeals are worth the break with past presidential behavior and national unity. For his detractors, the actions of Trump and his administration represent a serious abrogation of presidential norms and mark a dangerous shift away from pluralist democracy and toward more authoritarian nationalism. Many other voters with less intense feelings about Trump are just trying to put the whole spectacle out of their minds and to find some semblance of normalcy in a politically fractured environment. For those who study public attitudes about government itself, the Trump presidency raises serious questions about whether the United States is experiencing real, long-lasting changes in voters' attitudes toward government, or if Americans are reacting in intense but more typical ways that are consistent with past trends. To examine these issues in more detail, the Center for American Progress, along with its colleagues at Hart Research Associates, designed a comprehensive national survey to measure basic beliefs about government and specific voter attitudes about the Trump administration. The online survey of 1,500 registered voters nationally was conducted March 19–25, 2018, and has an overall margin of error of +/- 2.6 percent. This study builds upon a major public opinion study that CAP and Hart conducted in 2015, which examined public attitudes about government and explored a variety of proposals for improving the performance and representation of the government in Washington. The results of that research are summarized in the unpublished May 2016 report, "Of the People, By the People, For the People? A National Study of Public Trust and Confidence in Government."1Based on the results of the current study and comparisons with earlier responses from the 2015 research and other publicly available data, we believe that reactions to the Trump administration represent a genuine break with past public views of government in significant ways. Most importantly, the partisan divisions on measures of trust and confidence in government found in earlier research are now fully solidified. Many American voters today are not basing their evaluations of government on objective criteria that weigh policy choices and overall performance in a neutral manner. Rather, in-party and out-party voters are reacting in entirely divergent ways to the government itself based primarily upon who is leading the government and which party is in control

Climate geoengineering: issues of path-dependence and socio-technical lock-in

As academic and policy interest in climate geoengineering grows, the potential irreversibility of technological developments in this domain has been raised as a pressing concern. The literature on socio-technical lock-in and path dependence is illuminating in helping to situate current concerns about climate geoengineering and irreversibility in the context of academic understandings of historical socio-technical development and persistence. This literature provides a wealth of material illustrating the pervasiveness of positive feedbacks of various types (from the discursive to the material) leading to complex socio-technical entanglements which may resist change and become inflexible even in the light of evidence of negative impacts. With regard to climate geoengineering, there are concerns that geoengineering technologies might contribute so-called ‘carbon lock-in’, or become irreversibly ‘locked-in’ themselves. In particular, the scale of infrastructures that geoengineering interventions would require, and the issue of the so-called ‘termination effect’ have been discussed in these terms. Despite the emergent and somewhat ill-defined nature of the field, some authors also suggest that the extant framings of geoengineering in academic and policy literatures may already demonstrate features recognizable as forms of cognitive lock-in, likely to have profound implications for future developments in this area. While the concepts of path-dependence and lock-in are the subject of ongoing academic critique, by drawing analytical attention to these pervasive processes of positive feedback and entanglement, this literature is highly relevant to current debates around geoengineering

Trypanosoma brucei Modifies the Tsetse Salivary Composition, Altering the Fly Feeding Behavior That Favors Parasite Transmission

Tsetse flies are the notorious transmitters of African trypanosomiasis, a disease caused by the Trypanosoma parasite that affects humans and livestock on the African continent. Metacyclic infection rates in natural tsetse populations with Trypanosoma brucei, including the two human-pathogenic subspecies, are very low, even in epidemic situations. Therefore, the infected fly/host contact frequency is a key determinant of the transmission dynamics. As an obligate blood feeder, tsetse flies rely on their complex salivary potion to inhibit host haemostatic reactions ensuring an efficient feeding. The results of this experimental study suggest that the parasite might promote its transmission through manipulation of the tsetse feeding behavior by modifying the saliva composition. Indeed, salivary gland Trypanosoma brucei-infected flies display a significantly prolonged feeding time, thereby enhancing the likelihood of infecting multiple hosts during the process of a single blood meal cycle. Comparison of the two major anti-haemostatic activities i.e. anti-platelet aggregation and anti-coagulation activity in these flies versus non-infected tsetse flies demonstrates a significant suppression of these activities as a result of the trypanosome-infection status. This effect was mainly related to the parasite-induced reduction in salivary gland gene transcription, resulting in a strong decrease in protein content and related biological activities. Additionally, the anti-thrombin activity and inhibition of thrombin-induced coagulation was even more severely hampered as a result of the trypanosome infection. Indeed, while naive tsetse saliva strongly inhibited human thrombin activity and thrombin-induced blood coagulation, saliva from T. brucei-infected flies showed a significantly enhanced thrombinase activity resulting in a far less potent anti-coagulation activity. These data clearly provide evidence for a trypanosome-mediated modification of the tsetse salivary composition that results in a drastically reduced anti-haemostatic potential and a hampered feeding performance which could lead to an increase of the vector/host contact and parasite transmission in field conditions

Human resources for health care delivery in Tanzania: a multifaceted problem

BACKGROUND: Recent years have seen an unprecedented increase in funds for procurement of health commodities in developing countries. A major challenge now is the efficient delivery of commodities and services to improve population health. With this in mind, we documented staffing levels and productivity in peripheral health facilities in southern Tanzania. METHOD: A health facility survey was conducted to collect data on staff employed, their main tasks, availability on the day of the survey, reasons for absenteeism, and experience of supervisory visits from District Health Teams. In-depth interview with health workers was done to explore their perception of work load. A time and motion study of nurses in the Reproductive and Child Health (RCH) clinics documented their time use by task. RESULTS: We found that only 14% (122/854) of the recommended number of nurses and 20% (90/441) of the clinical staff had been employed at the facilities. Furthermore, 44% of clinical staff was not available on the day of the survey. Various reasons were given for this. Amongst the clinical staff, 38% were absent because of attendance to seminar sessions, 8% because of long-training, 25% were on official travel and 20% were on leave. RCH clinic nurses were present for 7 hours a day, but only worked productively for 57% of time present at facility. Almost two-third of facilities had received less than 3 visits from district health teams during the 6 months preceding the survey. CONCLUSION: This study documented inadequate staffing of health facilities, a high degree of absenteeism, low productivity of the staff who were present and inadequate supervision in peripheral Tanzanian health facilities. The implications of these findings are discussed in the context of decentralized health care in Tanzania

The point-prevalence of alcohol use disorders and binge drinking in an Irish general hospital.

There is a paucity of data concerning the prevalence of alcohol use disorders and binge drinking in the general hospital adult population in Ireland. The authors examined the point-prevalence of alcohol use disorders and of binge drinking in the adult inpatient population of the acute wards of an Irish university teaching hospital. The secondary aim was to examine gender, age, and patient group (medical/surgical) as risk factors. The authors administered the Alcohol Use Disorders Identification Test (AUDIT) to all consenting patients (n=126) on the acute adult medical and surgical wards over one day. 76% of all inpatients on the acute medical and surgical wards were interviewed (n=126) using the AUDIT. Of the subjects 28% screened positive for an alcohol use disorder. Of these 91% were identified as binge drinkers. A further 8% of the subjects screened positive for binge drinking but were not identified as having an alcohol use disorder. Overall, 36% of the subjects screened positive for either an alcohol use disorder and/or for binge drinking using the AUDIT. Male gender and under 65s were risk factors for both alcohol use disorders and binge drinking. The high point-prevalences of alcohol use disorders and binge drinking in hospital inpatients in particular are a cause for concern as they may have illness complicated by or secondary to undiagnosed alcohol excess. As this population is an easily accessible group for screening, and clinical and economic evidence supports intervention, we recommend screening all acute hospital admissions for alcohol use disorders and binge drinking, followed by appropriate management

A Gambian infant with fever and an unexpected blood film.

The authors describe the differential diagnosis, investigation, and management of a two-month-old infant with edema, malnutrition, and fever

Less is more: Development and evaluation of an interactive e-atlas to support anatomy learning

An Interactive electronic Atlas (IeA) was developed to assist first-year nursing students with interpretation of laboratory-based prosected cadaveric material. It was designed, using pedagogically sound principles, as a student-centered resource accessible to students from a wide range of learning backgrounds. It consisted of a highly simplified interactive interface limited to essential anatomical structures and was intended for use in a blended learning situation. The IeA's nine modules mirrored the body systems covered in a Nursing Biosciences course, with each module comprising a maximum of 10 pages using the same template: an image displaying a cadaveric specimen and, in most cases, a corresponding anatomical model with navigation panes (menus) on one side. Cursor movement over the image or clicking the menu highlighted the structure with a transparent overlay and revealed a succinct functional description. The atlas was complemented by a multiple-choice database of nearly 1,000 questions using IeA images. Students' perceptions of usability and utility were measured by survey (n = 115; 57% of the class) revealing mean access of 2.3 times per week during the 12-week semester and a median time of three hours of use. Ratings for usability and utility were high, with means ranging between 4.24 and 4.54 (five-point Likert scale; 5 = strongly agree). Written responses told a similar story for both usability and utility. The role of providing basic computer-assisted learning support for a large first-year class is discussed in the context of current research into student-centered resources and blended learning in human anatomy