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Patients with posttraumatic stress disorder (PTSD) exhibit smaller regional brain volumes in commonly reported regions including the amygdala and hippocampus, regions associated with fear and memory processing. In the current study, we have conducted a voxel-based morphometry (VBM) meta-analysis using whole-brain statistical maps with neuroimaging data from the ENIGMA-PGC PTSD working group.
Methods
T1-weighted structural neuroimaging scans from 36 cohorts (PTSD n = 1309; controls n = 2198) were processed using a standardized VBM pipeline (ENIGMA-VBM tool). We meta-analyzed the resulting statistical maps for voxel-wise differences in gray matter (GM) and white matter (WM) volumes between PTSD patients and controls, performed subgroup analyses considering the trauma exposure of the controls, and examined associations between regional brain volumes and clinical variables including PTSD (CAPS-4/5, PCL-5) and depression severity (BDI-II, PHQ-9).
Results
PTSD patients exhibited smaller GM volumes across the frontal and temporal lobes, and cerebellum, with the most significant effect in the left cerebellum (Hedges’ g = 0.22, pcorrected = .001), and smaller cerebellar WM volume (peak Hedges’ g = 0.14, pcorrected = .008). We observed similar regional differences when comparing patients to trauma-exposed controls, suggesting these structural abnormalities may be specific to PTSD. Regression analyses revealed PTSD severity was negatively associated with GM volumes within the cerebellum (pcorrected = .003), while depression severity was negatively associated with GM volumes within the cerebellum and superior frontal gyrus in patients (pcorrected = .001).
Conclusions
PTSD patients exhibited widespread, regional differences in brain volumes where greater regional deficits appeared to reflect more severe symptoms. Our findings add to the growing literature implicating the cerebellum in PTSD psychopathology.
The murder of George Floyd in May 2020 sparked a wave of Black Lives Matter protests in many cities throughout the United States. Protesters’ demands ranged from constraints on police use of force to defunding and disbanding the police altogether. These have led some to worry about the possibility of a “Ferguson Effect,” where police withdraw from policing, and in particular discretionary stops and searches, with deleterious consequences for crime. Drawing on data from four cities, we evaluate whether the 2020 BLM protests impacted police behavior, and whether changes in policing negatively impacted public safety. Regression discontinuity-in-time estimates suggest that although depolicing followed the BLM protests, in some respects the quality of policing improved, and public safety was not clearly impacted. Our findings have important implications for research on policing, social movements, and structural inequality in cities.
The 2014 US National Strategy for Combating Antibiotic-Resistant Bacteria (CARB) aimed to reduce inappropriate inpatient antibiotic use by 20% for monitored conditions, such as community-acquired pneumonia (CAP), by 2020. We evaluated annual trends in length of therapy (LOT) in adults hospitalized with uncomplicated CAP from 2013 through 2020.
Methods:
We conducted a retrospective cohort study among adults with a primary diagnosis of bacterial or unspecified pneumonia using International Classification of Diseases Ninth and Tenth Revision codes in MarketScan and the Centers for Medicare & Medicaid Services databases. We included patients with length of stay (LOS) of 2–10 days, discharged home with self-care, and not rehospitalized in the 3 days following discharge. We estimated inpatient LOT based on LOS from the PINC AI Healthcare Database. The total LOT was calculated by summing estimated inpatient LOT and actual postdischarge LOT. We examined trends from 2013 to 2020 in patients with total LOT >7 days, which was considered an indicator of likely excessive LOT.
Results:
There were 44,976 and 400,928 uncomplicated CAP hospitalizations among patients aged 18–64 years and ≥65 years, respectively. From 2013 to 2020, the proportion of patients with total LOT >7 days decreased by 25% (68% to 51%) among patients aged 18–64 years and by 27% (68%–50%) among patients aged ≥65 years.
Conclusions:
Although likely excessive LOT for uncomplicated CAP patients decreased since 2013, the proportion of patients treated with LOT >7 days still exceeded 50% in 2020. Antibiotic stewardship programs should continue to pursue interventions to reduce likely excessive LOT for common infections.
Minority voters have experienced a renewed effort to curtail their access to the ballot box in recent years. Although a host of research has examined the impact of election changes on Black and Latino voters, scholars have dedicated much less attention to the rights of Native Americans, even as they face challenges to voting in states where they comprise a significant portion of the population. Many of these states are likewise increasingly important to national elections. Such laws may impact Native Americans when they intersect with the political geography of living on a reservation, and voting rights advocates have challenged them in places like Montana, Nevada and North Dakota. This paper empirically evaluates how such laws might uniquely impact Native American voters. We draw on North Dakota's voter identification law as a case study, but our analysis has wider implications, since residency is the primary means by which election administration uniquely impacts this group. Drawing on two rich survey datasets collected in 2015 and 2017, we offer descriptive evidence of the barriers individuals may encounter while trying to obtain an ID under North Dakota's law, and find that Native Americans are statistically less likely to have access to an ID than are whites. This gap is largely due to the requirement that an ID has a physical address and attendant difficulties in obtaining such an ID, given the remote nature of reservations. We bring needed attention to the impact of carefully crafted electoral rules on this often-overlooked group.
How do involuntary interactions with authoritarian institutions shape political engagement? The policy feedback literature suggests that interactions with authoritarian policies undercut political participation. However, research in racial and ethnic politics offers reason to believe that these experiences may increase citizens’ engagement. Drawing on group attachment and discrimination research, we argue that mobilization is contingent on individuals’ political psychological state. Relative to their counterparts, individuals with a politicized group identity will display higher odds of political engagement when exposed to authoritarian institutions. To evaluate our theory, we draw on the 2016 Collaborative Multiracial Post-Election Study to examine the experiences of Blacks, Latinos, and Asian Americans. For all subgroups and different types of institutions, we find that, for those with a politicized group identity, institutional contact is associated with higher odds of participation. Our research modifies the classic policy feedback framework, which neglects group-based narratives in the calculus of collective action.
This essay explores four key dimensions of political science literature on the U.S. criminal legal system, by way of introducing articles in the special issue on criminal justice featured in the Journal of Racial and Ethnic Politics. We situate police as an institution of social control, rather than providing safety for people vulnerable to crime. The vast array of policy tools to surveil, track, and detain citizens, which lack commensurate restraints on their application, amount to a finely tuned carceral machine that can be deployed against groups newly identified as deviant. We therefore turn attention to this dynamic with our second theme: the criminalization of immigrants, the expansion of interior immigration enforcement, and the consequent targeting of Latinx people. We likewise discuss lessons for reform that can be drawn from research on representation and the political socialization that occurs as a consequence of involuntary contact with the system. We conclude with a brief discussion of directions for future research. The criminal legal system is a key force for persistent racial and class inequality. By turning attention to the politics of the criminal legal system, we forward a critical and understudied facet of American political life that intersects with all corners of the discipline.
This paper examines the effect of institutional contact on political participation among non-White communities. While both formal and informal institutions help shape community citizen participation, their effects vary on the historical inclusion (or exclusion) of certain racial groups. Formal institutions, like political parties, have historically excluded or neglected non-White and immigrant voters. We argue that for the excluded or neglected, non-traditional political institutions, like community based organizations, serve as supplements to facilitate political incorporation and engagement. These informal institutions help develop skills and resources among their constituents, and offer routine opportunities to participate. We use the 2008 Collaborative Multi-racial Post-Election Survey (CMPS) to test the differential effects of self-reported voter mobilization through nonpartisan and partisan institutional contact to explain variations among racial groups by the intensity of contact, occurrence of co-ethnic outreach, and type of institutional mobilization. We find that while contact by a partisan/political institution, like a political party or campaign, has an overall positive effect on political participation for all voters, contact by a nonpartisan/civic or community group is substantively more important for Latino and Asian American voter mobilization. Our analysis therefore offers cohesive evidence of how voters interact with and are affected by mobilization efforts that attends to differences across racial and ethnic boundaries, and variations in institutional contact.
A growing body of research explores the influence of involuntary criminal justice contact on political participation, demonstrating that all types of contact weaken political participation. We posit, however, that personal connections to civil society organizations (CSOs) moderate the negative effects of involuntary criminal justice contact on political participation, particularly political activism beyond registering to vote and voting. We test this proposition with individual-level and aggregate-level data from metropolitan and municipal Chicago. Our findings confirm a paradox of participation by custodial citizens. One, we demonstrate positive, statistically significant, and substantive effects of personal connections to CSOs on nonvoting political participation by custodial citizens. Two, the negative effects of involuntary criminal justice contact on voting participation among individuals and communities may endure, despite personal connections to CSOs, even in a state where the franchise is restored immediately after incarceration. Our study suggests that an associational account of political participation deepens our understanding of the political behavior of custodial citizens and their communities in the age of mass incarceration.
Anecdotal evidence suggests that Muslim American women who wear the hijab may be particularly vulnerable to the experiences of stigmatization because the hijab represents one of the most obvious and dominant markers of “otherness.” Yet, extant research has surprisingly neglected to systematically examine how such external markers of difference can increase perceptions of discrimination. Drawing from two nationally representative datasets, we examine perceived discrimination among Muslim Americans, and find that veiled women report experiencing both societal and institutional discrimination at much higher rates than their counterparts. In fact, our findings show that the hijab is one of the most important predictors of self-reported discrimination among all Muslim Americans. Interestingly, however, we also find that men are more likely than women to perceive discrimination once we account for the role of the hijab. Our analysis makes an important contribution to existing research by highlighting the unique experiences of a religious minority group and identifies one important and previously underexplored mechanism by which individuals may be targeted for discrimination—the hijab.
This paper examines the political implications of the criminal justice system for those who experience it indirectly: the friends and extended families of individuals who become caught up in the criminal justice system through heightened police surveillance, arrest, probation/parole and incarceration, which scholars have termed “custodial citizenship” (Lerman and Weaver 2014, 8). Contact with the criminal justice system is increasingly common in the United States, which incarcerates more of its citizens than any other western democracy (West, Sabol, and Greenman 2010). In addition to the 2.3 million people currently behind bars scholars estimate that more than 19 million have a felony (Uggen, Manza, and Thompson 2006). Fully 23% of Black adults have a criminal background, and Latinos make up 50% of federal inmates, highlighting extreme racial disparities in American criminal justice (Meissner et al. 2013). A growing body of research explores the impact of criminal justice contact on political participation finding that depressed voter turnout is the result whether one has been incarcerated, arrested, or lives in a high-contact community (Burch 2011, 2013; Lerman and Weaver 2014).
Through this study we aimed to assess the educational level and employment status of adults with CHD in Germany.
Methods
Data were acquired from an online survey carried out in 2015 by the German National Register for Congenital Heart Defects. A total of 1458 adults with CHD participated in the survey (response rate: 37.6%). For 1198 participants, detailed medical information, such as main cardiac diagnosis and information from medical reports, was available.
Results
Of the participants surveyed (n=1198), 54.5% (n=653) were female, and the mean age was 30 years. The majority of respondents (59.4%) stated that they had high education levels and that they were currently employed (51.1%). Patients with simple CHD had significantly higher levels of education (p<0.001) and were more likely to be employed (p=0.01) than were patients with complex CHD.
Conclusions
More than half of the participants had high education levels and the majority were employed. The association between CHD and its severity and individuals’ educational attainment should be investigated more closely in future studies.
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