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The Demand for Businessperson Politicians: How Do Businesspeople Win Electoral Nominations and Votes?
No full textBusinesspeople are a highly represented occupational group in the governments of many countries. What electoral strategies do these businessperson politicians employ that afford them high electoral success? In a context where non-programmatic electoral strategies are common and when faced with strong constraints on the utilization of personal, party, and public resources for distributive purposes, I argue that businessperson candidates' access to private sector resources provides them with an alternative set of distributive resources that can be used to pursue political support, thereby granting businessperson candidates with an electoral advantage over other occupational groups. Businessperson candidates are able to distribute private sector jobs to build an army of political workers who can provide political services. To test my arguments, I conducted list experiments with 986 employees in firms of businessperson candidates in Thailand. I find that employees in firms of businessperson candidates provide political services such as voting for the businessperson candidate, attending rallies, persuading acquaintances to support the businessperson candidate, and distributing goods and services produced by the firm to voters. Businessperson candidates, however, face a risk of shirking by patronage employees once hired. To overcome the commitment problem, I find that businessperson candidates rely on monitoring and negative inducements, in the form of employment termination threats, to mobilize these patronage employees to provide political services.</p
Recovery following adult spinal deformity surgery: the effect of complications and reoperation in 149 patients with 2-year follow-up.
No full textPurposeTo identify the effect of complications and reoperation on the recovery process following adult spinal deformity (ASD) surgery by examining health-related quality of life (HRQOL) measures over time via an integrated health state analysis (IHS).MethodsA retrospective review of a multicenter, prospective ASD database was conducted. Complication number, type, and need for reoperation (REOP) or not (NOREOP) were recorded. Patients were stratified as having no complication (NOCOMP), any complication (COMP), only minor complications (MINOR) and any major complications (MAJOR). HRQOL measures included Oswestry Disability Index (ODI), Short Form-36 (SF-36), and Scoliosis Research Society-22 (SRS22) at baseline, 6 weeks, 1 and 2 years postoperatively. All HRQOL scores were normalized to each patient's baseline scores and an IHS was then calculated.Results149 patients were included. COMP, MINOR, and MAJOR had significantly lower normalized SRS mental scores at 1 and 2 years than NOCOMP (p ConclusionAn IHS analysis suggests there was a significantly protracted mental recovery phase associated with patients that had at least one complication, as well as either a minor and major complication. The addition of a reoperation also adversely affected the mental recovery as well as overall satisfaction
The Adaptive, Pain Sensitive, and Global Symptoms Clusters: Evidence from a Patient-Based Study.
No full textObjectivesThe largest epidemiologic study conducted about painful temporomandibular disorders (pTMDs) to date identified 3 clusters of individuals with similar symptoms-adaptive, pain sensitive, and global symptoms-which hold promise as a means of personalizing pain care. Our goal was to compare the clinical and psychological characteristics that are consistent with a pTMD clinical examination among patients who are seeking care and assigned to the different clusters.MethodsThis cross-sectional study used data from the medical records of patients attending Duke Innovative Pain Therapies between August 2017 and April 2021 who received a pTMD diagnosis (i.e., myalgia) and consented to have their data used for research. Data included orofacial and pain-related measures, dental features, and psychological measures. We used the Rapid OPPERA Algorithm to assign clusters to patients and multinomial regression to determine the likelihood (odds ratios [OR] and 95% confidence intervals [CI]) of being assigned to the pain sensitive or global symptoms cluster attributed to each measure.ResultsIn total, 131 patients were included in this study and assigned a cluster: adaptive (n = 54, 41.2%), pain sensitive (n = 49, 37.4%), and global symptoms (n = 28, 21.4%). The PS cluster displayed greater numbers of temporomandibular joint sites (OR, 1.29; 95% CI, 1.01 to 1.65) and masticatory (1.48; 1.19 to 1.83) and cervical (1.23; 1.09 to 1.39) muscles with pain evoked by palpation. The GS cluster displayed greater scores of pain catastrophizing (1.04; 1.01 to 1.06) and perceived stress (1.23; 1.03 to 1.46) and was more likely to report persistent pain (16.23; 1.92 to 137.1) of higher impact (1.43; 1.14 to 1.80).ConclusionOur findings support that care-seeking patients with pTMDs who are assigned to the GS cluster display a poorer psychological profile, even though those assigned to the PS cluster display more measures consistent with orofacial pain. Findings also establish the PS cluster as a group that does not display psychological comorbidities despite being hypersensitive.Knowledge transfer statementThis study informs clinicians that patients seeking care for painful temporomandibular disorders, in specific cases of myalgia, can be classified into 1 of 3 groups that display unique profiles of symptoms. Most importantly, it emphasizes the importance of examining patients with painful temporomandibular disorders in a holistic manner that includes assessing symptoms of psychological distress. Patients with greater psychological distress will likely benefit from multidisciplinary treatment strategies that may include psychological treatments
The medicolegal impact of misplaced pedicle and lateral mass screws on spine surgery in the United States.
No full textSpine surgery has been disproportionately impacted by medical liability and malpractice litigation, with the majority of claims and payouts related to procedural error. One common area for the potential avoidance of malpractice claims and subsequent payouts involves misplaced pedicle and/or lateral mass instrumentation. However, the medicolegal impact of misplaced screws on spine surgery has not been directly reported in the literature. The authors of the current study aimed to describe this impact in the United States, as well as to suggest a potential method for mitigating the problem.This retrospective analysis of 68 closed medicolegal cases related to misplaced screws in spine surgery showed that neurosurgeons and orthopedic spine surgeons were equally named as the defendant (n = 32 and 31, respectively), and cases were most commonly due to misplaced lumbar pedicle screws (n = 41, 60.3%). Litigation resulted in average payouts of 753,832 between 1995 and 2019, when adjusted for inflation. The median time to case closure was 56.3 (35.2-67.2) months when ruled in favor of the plaintiff (i.e., patient) compared to 61.5 (51.4-77.2) months for defendant (surgeon) verdicts (p = 0.117)
External threat, internal rivalry, and alliance formation
No full textHistory reveals enemies often ally to confront a common threat. In such competitive coalitions actors must balance the simultaneous risk of distrust of their ally against external danger. We model this interactive relationship and generate several novel outcomes. Intra-alliance rivalry forces allying players to preemptively commit more resources to conflict and to free ride less. Consequently, their likelihood of conflict success increases. However, intra-alliance instability forces weaker players to commit a higher proportion of resources to fighting than do their stronger allies. This outcome runs contrary to Mancur Olson’s classic collective action result that the “small exploit the great.” Furthermore, allies do not demonstrate a uniform preference for bandwagoning or balancing. In general, it is preferable to bandwagon with friends but to balance with enemies. Finally, because rivalry can raise alliance payoffs, actors may rationally seek out risky partnerships with so-called enemies rather than molding more certain alliances with friends
Correlation of the Modified Japanese Orthopedic Association With Functional and Quality-of-Life Outcomes After Surgery for Degenerative Cervical Myelopathy: A Quality Outcomes Database Study.
No full textBackgroundThe modified Japanese Orthopedic Association (mJOA) score is a widely used and validated metric for assessing severity of myelopathy. Its relationship to functional and quality-of-life outcomes after surgery has not been fully described.ObjectiveTo quantify the association of the mJOA with the Neck Disability Index (NDI) and EuroQol-5 Dimension (EQ-5D) after surgery for degenerative cervical myelopathy.MethodsThe cervical module of the prospectively enrolled Quality Outcomes Database was queried retrospectively for adult patients who underwent single-stage degenerative cervical myelopathy surgery. The mJOA score, NDI, and EQ-5D were assessed preoperatively and 3 and 12 months postoperatively. Improvement in mJOA was used as the independent variable in univariate and multivariable linear and logistic regression models.ResultsAcross 14 centers, 1121 patients were identified, mean age 60.6 ± 11.8 years, and 52.5% male. Anterior-only operations were performed in 772 patients (68.9%). By univariate linear regression, improvements in mJOA were associated with improvements in NDI and EQ-5D at 3 and 12 months postoperatively (all P ConclusionImprovements in mJOA correlated weakly with improvements in NDI and EQ-5D, suggesting that changes in mJOA may not be a suitable proxy for functional and quality-of-life outcomes
Mapping Ecosystem Services for the Southeast United States: Conservation Priorities for Open Space Recreation Access
No full textThis methods brief focuses on access to recreational open space, which is a key component of mental health and well-being. This analysis maps the supply of publicly accessible open spaces relative to where people live. Regional priority areas for the creation of new open space through conservation are identified based on a metric representing the number of people who would benefit from new recreational open space if it were created in that area. Spatial datasets for these priority areas and associated metrics are available on ScienceBase