Honor, Shame, and Redemption: Explicating the American Evangelical Right\u27s Moral Worldview Regarding Same-Sex Marriage and Abortion

With the rise of the New Religious Right in American politics, same-sex marriage and abortion emerged as the seminal political issues in a burgeoning culture wars narrative. While previous literature in the sociology of religion and political science fields has examined conservative evangelical political mobilization around these issues, this literature has not adequately considered the primacy of theology in determining these critical political commitments of the evangelical right. This dissertation utilizes aspects of James Wellman\u27s concept of moral worldview, Ann Swidler\u27s ideas on the cultural toolkit, and Christian Smith\u27s subcultural identity theory to explore the formation of conservative evangelical social identity. In contrast to other works, however, this project asserts that theological orthodoxy directly dictates the most salient issues of political mobilization for members of the evangelical right. Key evangelical theological themes distill into three ideological frames that govern the conservative evangelical moral worldview and their political issue priorities. These ideological frames of moral purity/innocence, personal responsibility, and obedience to authority filter and limit the range of cultural tools available to conservative evangelicals in their experience of the world. Using content analysis to show how evangelical right leaders utilize these frames in their rhetoric, this project demonstrates how same-sex marriage and abortion emerge as the pivotal issues in the conservative evangelical mind. It argues that conservative evangelicals do not sort their sense of tribal identity into two categories of us and them, but rather three discrete categories of us, them, and potentially us, bringing the redemptive aspect of evangelical theology into their classification, reclassification and engagement with the Other. Combining the use of ideological frames with factors of threat and taboo, this dissertation demonstrates how evangelical theology directly produces moral claims and explicates how same-sex marriage and abortion have become a new political orthodoxy in an increasingly polarized American political landscape

Therapeutic Anticoagulation with Heparin in Critically Ill Patients with Covid-19.

BACKGROUND: Thrombosis and inflammation may contribute to morbidity and mortality among patients with coronavirus disease 2019 (Covid-19). We hypothesized that therapeutic-dose anticoagulation would improve outcomes in critically ill patients with Covid-19. METHODS: In an open-label, adaptive, multiplatform, randomized clinical trial, critically ill patients with severe Covid-19 were randomly assigned to a pragmatically defined regimen of either therapeutic-dose anticoagulation with heparin or pharmacologic thromboprophylaxis in accordance with local usual care. The primary outcome was organ support-free days, evaluated on an ordinal scale that combined in-hospital death (assigned a value of -1) and the number of days free of cardiovascular or respiratory organ support up to day 21 among patients who survived to hospital discharge. RESULTS: The trial was stopped when the prespecified criterion for futility was met for therapeutic-dose anticoagulation. Data on the primary outcome were available for 1098 patients (534 assigned to therapeutic-dose anticoagulation and 564 assigned to usual-care thromboprophylaxis). The median value for organ support-free days was 1 (interquartile range, -1 to 16) among the patients assigned to therapeutic-dose anticoagulation and was 4 (interquartile range, -1 to 16) among the patients assigned to usual-care thromboprophylaxis (adjusted proportional odds ratio, 0.83; 95% credible interval, 0.67 to 1.03; posterior probability of futility [defined as an odds ratio <1.2], 99.9%). The percentage of patients who survived to hospital discharge was similar in the two groups (62.7% and 64.5%, respectively; adjusted odds ratio, 0.84; 95% credible interval, 0.64 to 1.11). Major bleeding occurred in 3.8% of the patients assigned to therapeutic-dose anticoagulation and in 2.3% of those assigned to usual-care pharmacologic thromboprophylaxis. CONCLUSIONS: In critically ill patients with Covid-19, an initial strategy of therapeutic-dose anticoagulation with heparin did not result in a greater probability of survival to hospital discharge or a greater number of days free of cardiovascular or respiratory organ support than did usual-care pharmacologic thromboprophylaxis. (REMAP-CAP, ACTIV-4a, and ATTACC ClinicalTrials.gov numbers, NCT02735707, NCT04505774, NCT04359277, and NCT04372589.)