A Veteran Welfare State: Veterans\u27 Benefits, Coalition Politics, and Social Policy Change, 1943-1973

America’s commitment to the reintegration of veterans via social policy is not a recent political development; since the end of World War II, federal and state government programs have been designed (and redesigned) to successfully transition former military personnel back into civilian life. Beginning with the 1944 Serviceman’s Readjustment Act (commonly known as the G.I. Bill), the federal government has taken the primary role in this reintegration initiative, investing billions of dollars into veterans’ benefit programs for education assistance, unemployment compensation, and job placement services. Even as the legislation has been renewed after military conflicts, veterans’ education benefits have remained an integral part of the American social policy landscape in the post-New Deal era, providing critical tuition assistance for service members returning to a civilian workforce. As much as we know about the positive effects on American politics and economy generated by the original G.I. Bill and its successors, what do we know about the way that the legislation has been developed, or how it fits in with the broader set of (less popular) social policies in American history? I argue that veterans’ education benefits were supported by an unlikely political coalition (comprised of often diverging interests) that was tenuously united by the success of the 1944 G.I. Bill. As a result of this coalition’s competing social policy goals, the development of veterans’ education benefits siphoned political momentum away from broad-based education aid policies after 1944. Drawing on Congressional records, hearing transcripts, and archival data from over a dozen national libraries and private collections, I highlight the strategies of this “veterans’ benefit coalition,” as well as the ways in which the coalition worked toward expanding veterans’ benefits at the expense of programs for the entire citizenry (dovetailing with conservative interests to limit the growth of the American welfare state). The inclusion of this veterans’ benefit coalition – and its spillover effects – in the broader narrative of American welfare state development is a critical contribution to understanding America’s “laggard” welfare system in a comparative context

Presidents more likely to represent the concerns of white Americans than black Americans in speeches, yet Obama proves to be exception to rule

Using data from Gallup Poll’s “most important problem” question from 1969 to 2012 Melinda R. Tarsi, Jesse H. Rhodes, and Tatishe M. Nteta were able to evaluate whether Presidents addressed issues of importance to African Americans when delivering speeches to the public. Despite views held by many that Obama failed to represent black interests while in the White House, research found that he was the lone president to prioritize black issues over white issues in his major speeches

Mortality and Cardiovascular Disease among Older Live Kidney Donors

Over the past two decades, live kidney donation by older individuals (≥55 years) has become more common. Given the strong associations of older age with cardiovascular disease (CVD), nephrectomy could make older donors vulnerable to death and cardiovascular events. We performed a cohort study among older live kidney donors who were matched to healthy older individuals in the Health and Retirement Study. The primary outcome was mortality ascertained through national death registries. Secondary outcomes ascertained among pairs with Medicare coverage included death or CVD ascertained through Medicare claims data. During the period from 1996 to 2006, there were 5717 older donors in the United States. We matched 3368 donors 1:1 to older healthy nondonors. Among donors and matched pairs, the mean age was 59 years; 41% were male and 7% were black race. In median follow-up of 7.8 years, mortality was not different between donors and matched pairs (p = 0.21). Among donors with Medicare, the combined outcome of death/CVD (p = 0.70) was also not different between donors and nondonors. In summary, carefully selected older kidney donors do not face a higher risk of death or CVD. These findings should be provided to older individuals considering live kidney donation

Salmonella Biofilm Formation on Aspergillus niger Involves Cellulose – Chitin Interactions

Salmonella cycles between host and nonhost environments, where it can become an active member of complex microbial communities. The role of fungi in the environmental adaptation of enteric pathogens remains relatively unexplored. We have discovered that S. enterica Typhimurium rapidly attaches to and forms biofilms on the hyphae of the common fungus, Aspergillus niger. Several Salmonella enterica serovars displayed a similar interaction, whereas other bacterial species were unable to bind to the fungus. Bacterial attachment to chitin, a major constituent of fungal cell walls, mirrored this specificity. Pre-incubation of S. Typhimurium with N-acetylglucosamine, the monomeric component of chitin, reduced binding to chitin beads by as much as 727-fold and inhibited attachment to A. niger hyphae considerably. A cellulose-deficient mutant of S. Typhimurium failed to attach to chitin beads and to the fungus. Complementation of this mutant with the cellulose operon restored binding to chitin beads to 79% of that of the parental strain and allowed for attachment and biofilm formation on A. niger, indicating that cellulose is involved in bacterial attachment to the fungus via the chitin component of its cell wall. In contrast to cellulose, S. Typhimurium curli fimbriae were not required for attachment and biofilm development on the hyphae but were critical for its stability. Our results suggest that cellulose–chitin interactions are required for the production of mixed Salmonella-A. niger biofilms, and support the hypothesis that encounters with chitinaceous alternate hosts may contribute to the ecological success of human pathogens

Comparative effectiveness and safety of non-vitamin K antagonists for atrial fibrillation in clinical practice: GLORIA-AF Registry

Background and purpose: Prospectively collected data comparing the safety and effectiveness of individual non-vitamin K antagonists (NOACs) are lacking. Our objective was to directly compare the effectiveness and safety of NOACs in patients with newly diagnosed atrial fibrillation (AF). Methods: In GLORIA-AF, a large, prospective, global registry program, consecutive patients with newly diagnosed AF were followed for 3 years. The comparative analyses for (1) dabigatran vs rivaroxaban or apixaban and (2) rivaroxaban vs apixaban were performed on propensity score (PS)-matched patient sets. Proportional hazards regression was used to estimate hazard ratios (HRs) for outcomes of interest. Results: The GLORIA-AF Phase III registry enrolled 21,300 patients between January 2014 and December 2016. Of these, 3839 were prescribed dabigatran, 4015 rivaroxaban and 4505 apixaban, with median ages of 71.0, 71.0, and 73.0 years, respectively. In the PS-matched set, the adjusted HRs and 95% confidence intervals (CIs) for dabigatran vs rivaroxaban were, for stroke: 1.27 (0.79–2.03), major bleeding 0.59 (0.40–0.88), myocardial infarction 0.68 (0.40–1.16), and all-cause death 0.86 (0.67–1.10). For the comparison of dabigatran vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 1.16 (0.76–1.78), myocardial infarction 0.84 (0.48–1.46), major bleeding 0.98 (0.63–1.52) and all-cause death 1.01 (0.79–1.29). For the comparison of rivaroxaban vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 0.78 (0.52–1.19), myocardial infarction 0.96 (0.63–1.45), major bleeding 1.54 (1.14–2.08), and all-cause death 0.97 (0.80–1.19). Conclusions: Patients treated with dabigatran had a 41% lower risk of major bleeding compared with rivaroxaban, but similar risks of stroke, MI, and death. Relative to apixaban, patients treated with dabigatran had similar risks of stroke, major bleeding, MI, and death. Rivaroxaban relative to apixaban had increased risk for major bleeding, but similar risks for stroke, MI, and death. Registration: URL: https://www.clinicaltrials.gov. Unique identifiers: NCT01468701, NCT01671007. Date of registration: September 2013

Anticoagulant selection in relation to the SAMe-TT2R2 score in patients with atrial fibrillation. the GLORIA-AF registry

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores >2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores >2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score >2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores >2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores >2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007

Poster: The Interest of Defense: Individual and Contextual Influences on Defense Spending Preferences

How do both personal and contextual connections to the military shape Americans’ preferences on defense spending? As defense spending comes under scrutiny, increased attention turns towards the American electorate and what policies voters (and their representatives) are likely to support, based on their economic interests. Using the 2014 Cooperative Congressional Election Study and data on military installations in Congressional districts, I analyze the extent to which both personal connections to the military (through service) and contextual connections to the military (through the presence of installations in districts) affect individuals’ preferences concerning American defense spending. I find that, while military service does have modest effects on policy preferences, the contextual effect of a military installation\u27s presence is not sufficient to explain individual preferences on American defense spending

Self-selection Versus Socialization Revisited: Military Service, Racial Resentment, and Generational Membership

Scholarship on racial attitudes has found that white veterans of World War II and the Korean War had more positive views of blacks than white civilians. However, more recent studies have argued that white veterans who have served in an all-volunteer force (AVF) now express more virulent views of blacks. Using data from the 2010-2012 Cooperative Congressional Election Study, we explore whether military service continues to predict positive racial attitudes. We find that white veterans express more negative views of blacks relative to white civilians and that white veterans in the AVF generation exhibit the most negative views of blacks. Taken together, we believe that our results suggest a reassessment of the role of contemporary military experiences in liberalizing white racial attitudes and offer support for the self-selection perspective