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The Changing Nature of Mass Belief Systems: The Rise of Concept Ideologues & Policy Wonks
In today’s world of intense ideological conflict at the elite level, the nature of mass belief systems has changed dramatically since the last time Converse’s famous levels of conceptualization (Campbell et al., 1960; Converse, 1964) were coded in 2000. This paper shows that the percentage with well-developed belief systems based on a clear understanding of public policy choices has increased substantially since then. It also introduces a new category termed “policy wonks” to reflect a sub-category that Converse only referred to in passing but which is now quite common. Unlike respondents whom I classify as “concept ideologues” in this paper, policy wonks do not employ overarching concepts such as liberalism/conservatism or the scope of government. Rather, policy wonks just refer to at least three public policy stands when asked what they like and dislike about the major parties and presidential candidates. Although it was very rare for citizens in the 1950s to show a clear belief system based on the specific choices of government action, today’s highly intense and polarized policy debates have made programmatic-oriented belief systems quite common. A close examination of policy wonks shows that they are just as politically knowledgeable and consistent on issue dimensions as concept ideologues (i.e., those who employ ideological terms). Hence, policy wonks possess a well-defined belief system based on employing an understanding of public policy, thereby befitting Converse’s criteria for classification at the top level of conceptualization. The substantial increases in both concept ideologues and policy wonks accounts for virtually all of the increase since the 1980s in respondents whose partisanship matches their ideology (i.e., conservative Republicans and liberal Democrats). Not only are respondents at the top of levels of conceptualization more numerous than they used to be, but being more consistent than they used to be has led to a marked increase in the overall correspondence between partisanship and ideology. On the other hand, the decrease in ideologically inconsistent partisans (i.e., liberal Republicans and conservative Democrats) has occurred across all conceptualization levels. Thus, party polarization is a combination of: 1) better-developed belief systems increasing ideological-partisan consistency; and 2) partisan sorting decreasing partisans who are out step with their party’s ideological stance.Past research has shown that Republicans are substantially more likely to be ideologues whereas Democrats are much more inclined to conceptualize politics in terms of group benefits. This pattern was quite evident in the 2008 and 2012 American National Election Study (ANES) responses that I personally coded. However, two developments occurred in 2016 that dramatically reshaped the partisan nature of belief systems. First, the Bernie Sanders wing of the Democratic Party evidenced a great deal of ideological thinking, thereby pushing Democrats to a record percentage at the top level of ideological conceptualization. Second, the voters who supported Trump in the Republican primaries were much less likely to be ideologues or policy wonks than those who supported more traditional Republican candidates. These developments combined to make Democrats and Republicans more similar than ever before in terms of ideological conceptualization in 2016.
The face of the party? Leadership personalisation in British campaigns
The personal characteristics of political elites play an important role in British elections. While the personalisation of the media’s election coverage has been the subject of much debate, we know less about the conditions under which voters receive personalised messages directly from elites during the campaign. In this paper, we use a new dataset that includes more than 3,300 local communications from the 2015 general election to explore variation in the personalisation of campaign messaging. We find that there is systemic variation in terms of where photographs of party leaders are included in election communications, which provides further evidence that campaign messages are deployed strategically to portray the candidate – and their party – in the best possible light
Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts
Background: Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. Methods: This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1–15, 2002 (SOAP study, n = 3147), and May 8–18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO2 corresponding to the most abnormal value of arterial PO2 were recorded prospectively every 24 h. In both studies, patients were followed for outcome until death, hospital discharge or for 60 days. Results: The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1–7) days after admission in SOAP and 2 (1–6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH2O) and driving pressure (> 14 cmH2O) on the first day of mechanical ventilation but not tidal volume (> 8 ml/kg predicted body weight [PBW]) were independently associated with a higher risk of in-hospital death. Conclusion: The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH2O and driving pressure > 14 cmH2O on the first day of mechanical ventilation but not tidal volume > 8 ml/kg PBW were independently associated with a higher risk of death. These data highlight the continued burden of ARDS and provide hypothesis-generating data for the design of future studies
The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database
Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe
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