Information Gaps and Misinformation in the 2022 Elections

The prob­lem of elec­tion misin­form­a­tion is vast. Part of the prob­lem occurs when there is high demand for inform­a­tion about a topic, but the supply of accur­ate and reli­able inform­a­tion is inad­equate to meet that demand. The result­ing inform­a­tion gap creates oppor­tun­it­ies for misin­form­a­tion to emerge and spread.One major elec­tion inform­a­tion gap developed in 2020, when the Covid-19 pandemic drove many states to expand access to voting by mail. Inad­equate public know­ledge about the process left room for disin­form­a­tion mongers to spread false claims that mail voting would lead to wide­spread fraud. Elec­tion offi­cials could not fill inform­a­tion gaps with accur­ate inform­a­tion in time. As is now well known, no less than former Pres­id­ent Trump promoted these false claims, among others, to deny the 2020 pres­id­en­tial elec­tion results and provoke the Janu­ary 6, 2021, attack on the U.S. Capitol.In 2022, false narrat­ives about a stolen 2020 elec­tion persist, even as an unpre­ced­en­ted spate of restrict­ive voting law changes across the coun­try has created fresh inform­a­tion gaps and, thus, fresh oppor­tun­it­ies for misin­form­a­tion. Since 2020, at least 18 states have shrunk voting access, often in ways that dramat­ic­ally alter proced­ures voters might remem­ber from the past. Mean­while, lies and vitriol about the 2020 elec­tion have affected percep­tions of elec­tion admin­is­tra­tion in ways that complic­ate work to defend against misin­form­a­tion.This paper iden­ti­fies some of the most signi­fic­ant inform­a­tion gaps around elec­tions in 2022 and new devel­op­ments in elec­tions over­sight that will make it harder to guard against misin­form­a­tion. Ulti­mately, it recom­mends strategies that elec­tion offi­cials, journ­al­ists, social media compan­ies, civic groups, and indi­vidu­als can and should use to prevent misin­form­a­tion from filling gaps in public know­ledge. Lessons from other subjects, such as Covid-19 vaccine ingredi­ents and tech­no­lo­gies, show how timely responses and proact­ive "preb­unk­ing" with accur­ate inform­a­tion help to mitig­ate misin­form­a­tion

The Future of American Sentencing: A National Roundtable on Blakely

In the wake of the dramatic Supreme Court decision in Blakely v. Washington, Stanford Law School convened an assembly of the most eminent academic and professional sentencing experts in the country to jointly assess the meaning of the decision and its implications for federal and state sentencing reform. The event took place on October 8 and 9, just a few months after Blakely came down and the very week that the Supreme Court heard the arguments in United States v. Booker and United States v. Fanfan, the cases that will test Blakely\u27s application to the Federal Sentencing Guidelines. Thus the Roundtable offered these experts an intellectual breathing space at a crucial point in American criminal law. The event was built around six sessions, with shifting panels of participants doing brief presentations on the subject of the session, and with others then joining in the discussion. We are pleased that FSR is able to publish this version of the proceedings of the event-a condensed and edited transcript of the sessions

Primary Care and Youth Mental Health in Ireland: Qualitative Study in Deprived Urban Areas

BACKGROUND: Mental disorders account for six of the 20 leading causes of disability worldwide with a very high prevalence of psychiatric morbidity in youth aged 15-24 years. However, healthcare professionals are faced with many challenges in the identification and treatment of mental and substance use disorders in young people (e.g. young people\u27s unwillingness to seek help from healthcare professionals, lack of training, limited resources etc.) The challenge of youth mental health for primary care is especially evident in urban deprived areas, where rates of and risk factors for mental health problems are especially common. There is an emerging consensus that primary care is well placed to address mental and substance use disorders in young people especially in deprived urban areas. This study aims to describe healthcare professionals\u27 experience and attitudes towards screening and early intervention for mental and substance use disorders among young people (16-25 years) in primary care in deprived urban settings in Ireland. METHODS: The chosen method for this qualitative study was inductive thematic analysis which involved semi-structured interviews with 37 healthcare professionals from primary care, secondary care and community agencies at two deprived urban centres. RESULTS: We identified three themes in respect of interventions to increase screening and treatment: (1) Identification is optimised by a range of strategies, including raising awareness, training, more systematic and formalised assessment, and youth-friendly practices (e.g. communication skills, ensuring confidentiality); (2) Treatment is enhanced by closer inter-agency collaboration and training for all healthcare professionals working in primary care; (3) Ongoing engagement is enhanced by motivational work with young people, setting achievable treatment goals, supporting transition between child and adult mental health services and recognising primary care\u27s longitudinal nature as a key asset in promoting treatment engagement. CONCLUSIONS: Especially in deprived areas, primary care is central to early intervention for youth mental health. Identification, treatment and continuing engagement are likely to be enhanced by a range of strategies with young people, healthcare professionals and systems. Further research on youth mental health and primary care, including qualitative accounts of young people\u27s experience and developing complex interventions that promote early intervention are priorities

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Combustion emissions from a smoldering coal heap in north lanarkshire scotland

This presentation looks at combustion emissions from a smoldering coal heap in north lanarkshire scotlan

Spontaneous combustion of coal waste tips as a natural analogue for smouldering remediation methods.

Coal mining was widespread in the central belt of Scotland from 1830 until the 1970’s and created a legacy of waste tips or ‘bings’ that still dot the landscape. High content of coal fines and carbonaceous shales, make bings very prone to self-heating and smoldering combustion. A 30 m high waste heap at Bogside, North Lanarkshire, Scotland, started to smoulder in 2009, approximately 80 years after the closure of the pit and waste dumping. Induced smouldering, a flameless combustion process, of soils contaminated with tar, PAHs, heavy oils and other organic compounds is a promising technology for the remediation of brown field sites, but has hitherto been conducted on an experimental scale of several hundred tonnes. But the large scale phenomena of burning bings provide a unique opportunity to study a ‘natural’ analogue for smouldering remediation. Chemical, geotechnical and physical parameters of the Bogside Bing have been studied. A combustion front is moving from west to east along the axis of the tip at an approximate rate of 1m/month and three well-defined zones were identified and mapped using thermal imagery and temperature probes: the undisturbed zone, the preheating plus drying zone and the combustion zone. The subsurface fire is resulting in a detrimental effect to the vegetation and structural integrity of the heap. Spread of the combustion is accompanied by the development of vents ahead of the front and fissures that run parallel to the direction of heating and smaller landslips along the flanks. It is probable that changes to the soil mechanics’ of the tip induced by the smouldering front create a network of fissures, some running deep, that supply the front with enough air to sustain the process. Analysis of gas from the vents, show elevated CO2, CO, CH4 and SO2, and partially depleted in oxygen. All these are indicative of smouldering activity deep into the tip. The primary environmental concern is likely to be from SO2 release, although the stability of the structure may be compromised. Understanding the development of internal fissures and their role in sustaining the combustion process is crucial to utilizing smouldering as a remediation method for large areas of land contaminated by organic compounds. Bogside Bing continues to release products of combustion and represents an accidental source of fossil fuel burning

Psychosocial INTerventions for Alcohol use among problem drug users (PINTA): protocol for a feasibility study in primary care.

Background Alcohol use is an important issue among problem drug users. Although screening and brief intervention are effective in reducing problem alcohol use in primary care, no research has examined this issue among problem drug users. Objectives To determine if a complex intervention, incorporating screening and brief intervention for problem alcohol use among problem drug users, is feasible and acceptable in practice and effective in reducing the proportion of patients with problem alcohol use. Methods PINTA is a pilot feasibility study of a complex intervention comprising screening and brief intervention for problem alcohol use among problem drug users with cluster randomisation at the level of general practice, integrated qualitative process evaluation, and involving general practices in two socioeconomically deprived regions. Participants: Practices (N=16) will be eligible to participate if they are registered to prescribe methadone and/or at least 10 patients of the practice are currently receiving addiction-treatment. Patient inclusion criteria are: aged 18 or over and receiving addiction treatment / care (e.g. methadone) or known to be a problem drug user. Interventions: A complex intervention, supporting screening and brief intervention for problem alcohol use among problem drug users (experimental group) compared to an ‘assessment only’ control group. A delayed intervention being available to ‘control’ practices after follow up. Page 3 Outcome: Primary outcomes are feasibility and acceptability of the intervention to patients and professionals. Secondary outcome is the effectiveness of the intervention on care process (documented rates of screening and brief intervention) and outcome (proportion of patients with problem alcohol use at the follow up). Randomisation: Stratified random sampling of general practices based on level of training in providing addiction-related care and geographical area. Blinding: Single-blinded; GPs and practice staff, researchers and trainers will not be blinded, but patients and remote randomisers will. Discussion This is the first study to examine feasibility and acceptability of primary care based complex intervention to enhance alcohol screening and brief intervention among problem drug users. Results will inform future research among this high-risk population and guide policy and service development locally and internationally

Towards early intervention for youth mental health in primary care: a qualitative study of service provider perspectives in two deprived urban areas

Aims: Early intervention in youth mental health is increasingly viewed as easier, cheaper and more effective than traditional approaches to care. GPs, as the healthcare professional most often consulted by young people, have a central role in early detection of youth mental health and addiction disorders. However, international data suggests many young people have concerns bringing these issues to their GP, and GPs themselves experience difficulty identifying and treating mental health issues. The aim of this study is to gain an understanding of the experience of youth mental health and addiction treatment in two deprived urban areas to inform future early intervention practice development. Methods: Semi-structured interviews were recorded with 37 healthcare professionals. Inductive thematic analysis was carried out using QSR NVivo 9. Results: ‘Context’ suggests youth mental health issues are considerably influenced by wider societal context and local factors (e.g. family). Intervention suggests many barriers and enablers to helping young people, be that at the identification, treatment, or engagement stages of intervention. Conclusions: Many factors influence how a young person develops, seeks help for, and engages with treatment for mental and substance use disorders. This knowledge is useful in developing interventions in primary care that are specific to deprived urban areas