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This article argues that because racial inequalities are embedded in American society, as well as in medicine, more evidence-based investigation of the effects and implications of affirmative action is needed. Residency training programs should also seek ways to recruit medical students from underrepresented groups and to create effective mentorship programs.
Truth telling to persons living with dementia is a nuanced problem that demands negotiating between the hazards of principlism and the loving deceiver’s demand to lie as needed. To ban deception, as we do restraints, would be misguided and cruel. So too to demand we always tell the truth. We ought to adopt a practice called “creative care.” It begins with the premise that person’s living with dementia are capable of creativity. Creative care breaks down the mysterious fourth wall we build around persons living with dementia, especially persons with advanced dementia. It invites us to see a person living with dementia as a person who is capable of creating something beautiful. They need our time and words, not our lies and sedatives.
Over-the-counter (OTC) drugs are ubiquitous in the US. Policymakers have long debated how to modernize the system for making determinations of safety and effectiveness and addressing safety issues with OTC drugs.
This paper describes a computational investigation of multimode instability growth and multimaterial mixing induced by multiple shock waves in a high-energy-density (HED) environment, where pressures exceed 1 Mbar. The simulations are based on a series of experiments performed at the National Ignition Facility (NIF) and designed as an HED analogue of non-HED shock-tube studies of the Richtmyer–Meshkov instability and turbulent mixing. A three-dimensional computational modelling framework is presented. It treats many complications absent from canonical non-HED shock-tube flows, including distinct ion and free-electron internal energies, non-ideal equations of state, radiation transport and plasma-state mass diffusivities, viscosities and thermal conductivities. The simulations are tuned to the available NIF data, and traditional statistical quantities of turbulence are analysed. Integrated measures of turbulent kinetic energy and enstrophy both increase by over an order of magnitude due to reshock. Large contributions to enstrophy production during reshock are seen from both the baroclinic source and enstrophy–dilatation terms, highlighting the significance of fluid compressibility in the HED regime. Dimensional analysis reveals that Reynolds numbers and diffusive Péclet numbers in the HED flow are similar to those in a canonical non-HED analogue, but conductive Péclet numbers are much smaller in the HED flow due to efficient thermal conduction by free electrons. It is shown that the mechanism of electron thermal conduction significantly softens local spanwise gradients of both temperature and density, which causes a minor but non-negligible decrease in enstrophy production and small-scale mixing relative to a flow without this mechanism.
This chapter provides and overview of the book and uses the case of the 2013 election reform bill in North Carolina to illustrate the key arguments of the manuscript. Partisan majorities in states often change laws regarding the ballot format to help them remain in power. This chapter also describes the basic ballot types used in the U.S. and summarizes the findings of each chapter.
This chapter provides empirical analysis of ballot rolloff from 1940-2000. This era featured less partisan conflict than did the eras that came before and after this time period. One result of this is that ballot law changes were less partisan in nature and tended to work to benefit incument politicians. Our data demonstrate that ballot type faciltated growth in the incumbency advantage and produced lawmakers that were more effective at shepherding bills through the legislative process.
This chapter examines ballot formats in the United States from 1888 to 1940. Following the adoption of the Australian secret ballot states still had to decide the particular design of the new secret ballot. We show in this chapter that the decisions had enormous consequences for voter turnout and ballot roll-off at the state level. We provide detailed case studies of California, New York, and Maryland as well as an empirical analysis of voter turnout and ballot roll-off during this period.
This chapter provides detailed case studies of recent ballot reform efforts in Michigan and North Carolina. These states have detailed data on the level of straight ticket voting by county. These data are used to demonstrate how county characteristics such as race, ethnicity, and poverty interact with straight ticket voting and ballot rolloff. We find a strong connection between straight-ticket voting, minority populations, and ballot rolloff. This chapter concludes with analysis of recent changes in Iowa and West Virginia. The findings for Iowa suggest that the effects of ballot design changes are muted in areas that have lower proportions of non-white residents and that are less densely populated.
This chapter demonstrates how ballot formats can nudge voters. Applying concepts from behavioral economics, we argue that the structure in which choices are presented can nudge voters toward certain decisions. We then apply this theoretical structure to the major types of ballots used in the United States and develop expectations as to how various ballot formats will affect election outcomes.
US federalism grants state legislators the authority to design many aspects of election administration, including ballot features that mediate how citizens understand and engage with the choices available to them when casting their votes. Seemingly innocuous features in the physical design of ballots, such as the option to cast a straight ticket with a single checkmark, can have significant aggregate effects. Drawing on theoretical insights from behavioral economics and extensive data on state ballot laws from 1888 to the present, as well as in-depth case studies, this book shows how strategic politicians use ballot design to influence voting and elections, drawing comparisons across different periods in American history with varying levels of partisanship and contention. Engstrom and Roberts demonstrate the sweeping impact of ballot design on voting, elections, and democratic representation.