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Past work on closed-ended survey responses demonstrates that inferring stable political attitudes requires separating signal from noise in “top of the head” answers to researchers’ questions. We outline a corresponding theory of the open-ended response, in which respondents make narrow, stand-in statements to convey more abstract, general attitudes. We then present a method designed to infer those attitudes. Our approach leverages co-variation with words used relatively frequently across respondents to infer what else they could have said without substantively changing what they meant—linking narrow themes to each other through associations with contextually prevalent words. This reflects the intuition that a respondent may use different specific statements at different points in time to convey similar meaning. We validate this approach using panel data in which respondents answer the same open-ended questions (concerning healthcare policy, most important problems, and evaluations of political parties) at multiple points in time, showing that our method’s output consistently exhibits higher within-subject correlations than hand-coding of narrow response categories, topic modeling, and large language model output. Finally, we show how large language models can be used to complement—but not, at present, substitute—our “implied word” method.
Information on social media is characterized by networked curation processes in which users select other users from whom to receive information, and those users in turn share information that promotes their identities and interests. We argue this allows for partisan “curation bubbles” of users who share and consume content with consistent appeal drawn from a variety of sources. Yet, research concerning the extent of filter bubbles, echo chambers, or other forms of politically segregated information consumption typically conceptualizes information’s partisan valence at the source level as opposed to the story level. This can lead domain-level measures of audience partisanship to mischaracterize the partisan appeal of sources’ constituent stories—especially for sources estimated to be more moderate. Accounting for networked curation aligns theory and measurement of political information consumption on social media.
Critical Race Theory (CRT) has become a flashpoint of elite political discord, yet how Americans actually perceive CRT is unclear. We theorize that Republican elites utilized a strong framing strategy to re-define CRT as an “empty signifier” representing broader racial and cultural grievances. Using a survey and a pre-registered experiment among U.S. adults (N = 19,060), we find that this strategy worked. Republicans exhibit more familiarity with CRT and hold more negatively valenced (and wide ranging) sentiments toward CRT, relative to Democrats. Moreover, compared to teaching the legacy of racism in schools, Republicans are significantly more opposed to teaching CRT while Democrats express greater uncertainty. Our findings suggest that by framing CRT as a broad term that envelopes many grievances (including those beyond the scope of CRT), Republican elites have shaped a subset of Americans’ understanding of and attitudes toward CRT.
The COVID-19 pandemic has disproportionally affected the mental health of health and social care workers (HSCWs), with many experiencing symptoms of depression, anxiety and post-traumatic stress disorder. Psychological interventions have been offered via mental health services and in-house psychology teams, but their effectiveness in this context is not well documented.
Aims
To evaluate a stepped-care psychological support pathway for HSCWs from Homerton Healthcare Foundation Trust in London, which offered psychological first aid, evidence-based psychological therapies and group-based well-being workshops.
Method
The service evaluation used a pre–post approach to assess depression, anxiety, functional impairment and post-traumatic stress disorder symptom change for those who attended sessions of psychological first aid, low- or high-intensity cognitive–behavioural therapy or a combination of these. In addition, the acceptability of the psychological first aid sessions and well-being workshops was explored via feedback data.
Results
Across all interventions, statistically significant reductions of depression (d = 1.33), anxiety (d = 1.37) and functional impairment (d = 0.93) were observed, and these reductions were equivalent between the interventions, as well as the demographic and occupational differences between the HSCWs (ethnicity, staff group and redeployment status). HSCWs were highly satisfied with the psychological first aid and well-being workshops.
Conclusions
The evaluation supports the utility of evidence-based interventions delivered as part of a stepped-care pathway for HSCWs with common mental health problems in the context of the COVID-19 pandemic. Given the novel integration of psychological first aid within the stepped-care model as a step one intervention, replication and further testing in larger-scale studies is warranted.
Causal inference and machine learning are typically introduced in the social sciences separately as theoretically distinct methodological traditions. However, applications of machine learning in causal inference are increasingly prevalent. This Element provides theoretical and practical introductions to machine learning for social scientists interested in applying such methods to experimental data. We show how machine learning can be useful for conducting robust causal inference and provide a theoretical foundation researchers can use to understand and apply new methods in this rapidly developing field. We then demonstrate two specific methods – the prediction rule ensemble and the causal random forest – for characterizing treatment effect heterogeneity in survey experiments and testing the extent to which such heterogeneity is robust to out-of-sample prediction. We conclude by discussing limitations and tradeoffs of such methods, while directing readers to additional related methods available on the Comprehensive R Archive Network (CRAN).
Gun ownership is a highly consequential political behavior. It often signifies a belief about the inadequacy of state-provided security and leads to membership in a powerful political constituency. As a result, it is important to understand why people buy guns and how shifting purchasing patterns affect the composition of the broader gun-owning community. We address these topics by exploring the dynamics of the gun-buying spike that took place during the COVID-19 pandemic, which was one of the largest in American history. We find that feelings of diffuse threat prompted many individuals to buy guns. Moreover, we show that new gun owners, even more than buyers who already owned guns, exhibit strong conspiracy and anti-system beliefs. These findings have substantial consequences for the subsequent population of gun owners and provide insight into how social disruptions can alter the nature of political groups.
Politics and science have become increasingly intertwined. Salient scientific issues, such as climate change, evolution, and stem-cell research, become politicized, pitting partisans against one another. This creates a challenge of how to effectively communicate on such issues. Recent work emphasizes the need for tailored messages to specific groups. Here, we focus on whether generalized messages also can matter. We do so in the context of a highly polarized issue: extreme COVID-19 vaccine resistance. The results show that science-based, moral frame, and social norm messages move behavioral intentions, and do so by the same amount across the population (that is, homogeneous effects). Counter to common portrayals, the politicization of science does not preclude using broad messages that resonate with the entire population.
There is global interest in the reconfiguration of community mental health services, including primary care, to improve clinical and cost effectiveness.
Aims
This study seeks to describe patterns of service use, continuity of care, health risks, physical healthcare monitoring and the balance between primary and secondary mental healthcare for people with severe mental illness in receipt of secondary mental healthcare in the UK.
Method
We conducted an epidemiological medical records review in three UK sites. We identified 297 cases randomly selected from the three participating mental health services. Data were manually extracted from electronic patient medical records from both secondary and primary care, for a 2-year period (2012–2014). Continuous data were summarised by mean and s.d. or median and interquartile range (IQR). Categorical data were summarised as percentages.
Results
The majority of care was from secondary care practitioners: of the 18 210 direct contacts recorded, 76% were from secondary care (median, 36.5; IQR, 14–68) and 24% were from primary care (median, 10; IQR, 5–20). There was evidence of poor longitudinal continuity: in primary care, 31% of people had poor longitudinal continuity (Modified Modified Continuity Index ≤0.5), and 43% had a single named care coordinator in secondary care services over the 2 years.
Conclusions
The study indicates scope for improvement in supporting mental health service delivery in primary care. Greater knowledge of how care is organised presents an opportunity to ensure some rebalancing of the care that all people with severe mental illness receive, when they need it. A future publication will examine differences between the three sites that participated in this study.
Debates over the extent to which racial attitudes and economic distress explain voting behavior in the 2016 election have tended to be limited in scope, focusing on the extent to which each factor explains white voters’ two-party vote choice. This limited scope obscures important ways in which these factors could have been related to voting behavior among other racial sub-groups of the electorate, as well as participation in the two-party contest in the first place. Using the vote-validated 2016 Cooperative Congressional Election Survey, merged with economic data at the ZIP code and county levels, we find that racial attitudes strongly explain two-party vote choice among white voters—in line with a growing body of literature. However, we also find that local economic distress was strongly associated with non-voting among people of color, complicating direct comparisons between racial and economic explanations of the 2016 election and cautioning against generalizations regarding causal emphasis.
Patients may present to Emergency Departments (ED) in shock for various reasons. Emergency medicine physicians may require the use of vasopressors or inotropes to manage these patients. The Critical Care Practice Committee of the Canadian Association of Emergency Physicians (C4) conducted an intensive literature search and guideline development process to help create an evidence based approach for use of these agents in the stabilization of shock.
The ability to recover bacteria from frozen culture specimens has important implications. The purpose of this study was to validate the utility of frozen specimens for recovery of several gram-positive and gram-negative bacterial species by culture. Results demonstrate that 98% of 250 bacterial isolates identified on initial culture were subsequently recovered by culture of frozen specimens after a median storage period of 564 days.
Molecular laboratory techniques were used to study the epidemiology of an outbreak of nosocomial Legionnaires' disease. All patient isolates were Legionella pneumophila serogroup 1 and showed identical plasmid profiles and reactions with serogroup-specific monoclonal antibodies. L pneumophila was also cultured from four of five cooling tower water samples; however, the isolate from only one tower was serogroup 1 of the same sub-type as patient isolates. Since the cases were temporally clustered and epidemiologically associated with exposure to cooling tower aerosols, the single cooling tower implicated by molecular analysis was the most likely source of the outbreak. Chlorination of cooling tower ponds has eradicated the epidemic strain. Since potable water also harbored the infecting organism and was the probable source for cooling tower contamination, decontamination of the hospital water system was also undertaken. Superchlorination of hot water holding tanks to 17 ppm on a weekly basis has effectively eradicated L pneumophila from the potable water system and appears to be a reasonable, simple, and relatively inexpensive alternative to previously described methods of control.