NIMBY, YIMBY, or something else? Geographies of public perceptions of shale gas development in the Marcellus Shale

Much research exists on how social-psychological factors (e.g. political ideology), proximity to development, and contextual factors (e.g. state in which one resides) drive public attitudes toward various types of energy development. Yet, scholars have only recently begun to explore how these factors interact to create unique geographies of perception that defy the simplistic explanations suggested by not-in-my-backyard or yes-in-my-backyard labels. Using precisely geocoded well and survey data, we explore the interplay of political ideology, proximity and place in the context of public attitudes toward unconventional oil and natural gas development (UOGD) in the Marcellus Shale region of southern New York and northern Pennsylvania. For our full sample and similar to findings from recent national surveys on attitudes toward energy development, we found that respondents closer to UOGD were more supportive of it, a relationship that was moderated by political ideology with liberals or moderates located closer to UOGD more supportive than those located further away. However, when we examined these moderation effects within states, a different story emerged. For New York respondents, proximity did not appear to have a differential effect on conservatives vs. liberals/moderates. However, for Pennsylvania respondents, we observed opposing effects: conservatives were more supportive further away from development, while liberals/moderates were more supportive closer to development. Our results thus both reaffirm and challenge existing scholarship, highlighting the potential for middle range theorizing about geographies of perception in energy development

How geographic distance and political ideology interact to influence public perception of unconventional oil / natural gas development

A growing area of research has addressed public perception of unconventional oil and natural gas development via hydraulic fracturing (“fracking”). We extend this research by examining how geographic proximity to such extraction interacts with political ideology to influence issue support. Regression analysis of data from a fall 2013 national telephone survey of United States residents reveals that as respondents’ geographic distance from areas experiencing significant development increases, political ideology becomes more strongly associated with issue support, with the liberal-partisan divide widening. Our findings support construal level theory's central premise: that people use more abstract considerations (like political ideology) the more geographically removed they are from an issue. We discuss implications for studying public opinion of energy development as well as for risk communication

Effect of three wound dressings on infection, healing comfort, and cost in patients with sternotomy wounds - a randomized trial

Study objective: To compare three dressing types in terms of their ability to protect against infection and promote healing, patient comfort, and cost-effectiveness.Design: Prospective, randomized controlled trial.Setting: Major metropolitan, academically affiliated, tertiary referral center.Patients: Seven hundred thirty-seven patients were randomized to receive a dry absorbent dressing (n = 243) [Primapore; Smith &amp; Nephew; Sydney, NSW, Australia], a hydrocolloid dressing (n = 267) [Duoderm Thin ConvaTec; Mulgrave, VIC, Australia], or a hydroactive dressing (n = 227) [Opsite; Smith &amp; Nephew] in the operating theater on skin closure.Results: There was no difference in the rate of wound infection or wound healing between treatment groups. The Primapore dressing was the most comfortable and cost-effective dressing option for the sternotomy wound. Duoderm Thin dressings were associated with increased wound exudate (p &lt; 0.001), poor dressing integrity (p &lt; 0.001), more frequent dressing changes (p &lt; 0.001), more discomfort with removal (p &lt; 0.05), and increased cost (p &lt; 0.001).Conclusions: In the context of no additional benefit for the prevention of wound infection or the rate of wound healing for any of the three dressing products examined, dry absorbent dressings are the most comfortable and cost-effective products for sternotomy wounds following cardiac surgery.<br /

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

Public opinion on energy development: the interplay of issue framing, top-of-mind associations, and political ideology

In this article, we examine framing effects regarding unconventional oil and gas extraction using hydraulic fracturing (or fracking): an issue involving considerable controversy over potential impacts as well as terminology used to describe it. Specifically, we explore how two commonly used terms to describe this issue – fracking or shale oil or gas development – serve as issue frames and influence public opinion. Extending existing research, we suggest that these frames elicit different top-of-mind associations that reflect positive or negative connotations and resonate with people's political ideology. These associations, in turn, help explain direct and indirect framing effects on support/opposition as well as whether these effects differ by political ideology. Results of a split-ballot, national U.S. survey (n=1000) reveal that people are more supportive of the energy extraction process when it is referred to as shale oil or gas development versus fracking, and this relationship is mediated by greater perceptions of benefit versus risk. Political ideology did not moderate these effects. Further analysis suggests that these findings are partly explained by the tendency to associate fracking more with negative thoughts and impacts and shale oil or gas development more with positive thoughts and impacts. However, these associations also did not vary by political ideology. We discuss implications for communicating risk regarding energy development

Oxygen targets and 6-month outcome after out of hospital cardiac arrest: a pre-planned sub-analysis of the targeted hypothermia versus targeted normothermia after Out-of-Hospital Cardiac Arrest (TTM2) trial

International audienceAbstract Background Optimal oxygen targets in patients resuscitated after cardiac arrest are uncertain. The primary aim of this study was to describe the values of partial pressure of oxygen values (PaO 2 ) and the episodes of hypoxemia and hyperoxemia occurring within the first 72 h of mechanical ventilation in out of hospital cardiac arrest (OHCA) patients. The secondary aim was to evaluate the association of PaO 2 with patients’ outcome. Methods Preplanned secondary analysis of the targeted hypothermia versus targeted normothermia after OHCA (TTM2) trial. Arterial blood gases values were collected from randomization every 4 h for the first 32 h, and then, every 8 h until day 3. Hypoxemia was defined as PaO 2  300 mmHg. Mortality and poor neurological outcome (defined according to modified Rankin scale) were collected at 6 months. Results 1418 patients were included in the analysis. The mean age was 64 ± 14 years, and 292 patients (20.6%) were female. 24.9% of patients had at least one episode of hypoxemia, and 7.6% of patients had at least one episode of severe hyperoxemia. Both hypoxemia and hyperoxemia were independently associated with 6-month mortality, but not with poor neurological outcome. The best cutoff point associated with 6-month mortality for hypoxemia was 69 mmHg (Risk Ratio, RR = 1.009, 95% CI 0.93–1.09), and for hyperoxemia was 195 mmHg (RR = 1.006, 95% CI 0.95–1.06). The time exposure, i.e., the area under the curve (PaO 2 -AUC), for hyperoxemia was significantly associated with mortality ( p = 0.003). Conclusions In OHCA patients, both hypoxemia and hyperoxemia are associated with 6-months mortality, with an effect mediated by the timing exposure to high values of oxygen. Precise titration of oxygen levels should be considered in this group of patients. Trial registration : clinicaltrials.gov NCT02908308 , Registered September 20, 2016