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Scholarship on multimethod case selection in the social sciences has developed rapidly in recent years, but many possibilities remain unexplored. This essay introduces an attractive and advantageous new alternative, involving the selection of extreme cases on the treatment variable, net of the statistical influence of the set of known control variables. Cases that are extreme in this way are those in which the value of the main causal variable is as surprising as possible, and thus, this approach can be referred to as seeking "surprising causes." There are practical advantages to selecting on surprising causes, and there are also advantages in terms of statistical efficiency in facilitating case-study discovery. We first argue for these advantages in general terms and then demonstrate them in an application regarding the dynamics of U.S. labor legislation.

Objective: The objective of this study was to assess the impact of the coronavirus pandemic on gynecology surgical training. Methods: A national cross‐sectional online survey was distributed to all trainees and trainers in the higher specialist training program for obstetrics and gynecology in Ireland. The survey consisted of questions on topics which included: the volume of surgical procedures performed before and since the pandemic, confidence in performing various gynecologic procedures before and since the pandemic and questions regarding the impact of the pandemic on wellbeing and work practices. Results: Trainers and trainees experienced a significant reduction in operative volumes for most procedure types. Analysis showed a significant reduction in the number of minor procedures performed by trainees (z = −2.7, P = 0.007) and a significant reduction in the number of all procedure types performed by trainers (minor procedures z = −3.78, P = <0.001; intermediate procedures z = −4.48, P = < 0.001; major procedures z = −3.69, P = < 0.001). Respondents reported they had less time for research and audit, were less able to attend courses or conferences and worried about the impact of their work on their families. Conclusions: In conclusion, this study has highlighted the current difficulties facing surgical trainees in gynecology because of the COVID‐19 pandemic. These challenges have compounded an already challenging training environment for gynecology trainees. Efforts must be made to continue to provide high‐quality tailored training to ensure the development of the next generation of gynecologic surgeons. Synopsis: A national survey which shows significant challenges with training in gynecology during the coronavirus pandemic. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion To compare the risk profiles, anatomical, and functional outcomes between obese and non‐obese women who experienced obstetric anal sphincter injury (OASI).A retrospective electronic database study was conducted at Cork University Maternity Hospital (CUMH). Women with missing data/repairs conducted outside CUMH were excluded. Participants were categorized into obese (BMI ≥30 kg/m2) and non‐obese (BMI <30 kg/m2) groups. Primary measure was a composite adverse outcome assessed 6 months post‐delivery, including one or more of the following: resting pressure <40 mmHg, squeezing pressure <100 mmHg, defects in the internal and/or external anal sphincter. Statistical analyses were performed using SPSS version 28.Among the 349 women included in the study, 285 (81.7%) had a BMI <30 kg/m2 and 64 (18.3%) had a BMI ≥30 kg/m2. Gestational diabetes was significantly higher in obese women. No significant differences were observed in newborn weight or mode of delivery. The majority of tears were classified as grade 3B in both groups. Attendance rates at the OASI clinic did not differ between the groups. Among those attending, no statistical differences were noted in manometry results, which were reduced in both groups. Rates of internal anal sphincter defects were lower in the obese group (7.0% vs 15.6%, P = 0.15) and external anal sphincter defects were significantly lower in obese women (0% vs 9.1%, P = 0.04). No difference was found in the rates of composite adverse outcomes between the groups.Functional outcomes and manometry results did not differ, but non‐obese women had higher rates of anatomical defects in OASI, requiring further study. [ABSTRACT FROM AUTHOR]

We argue that American political development's (APD's) relentless preoccupation with the substantive problems that shape and animate American politics and how they emerge and develop over time has been a key source of the subfield's durability. We elaborate on three main payoffs to conceptualizing APD as a problem-driven enterprise: (1) it highlights APD's main comparative advantage within the American politics subfield, noting the tremendous agility APD's substantive breadth lends the enterprise; (2) it resolves the methodological debate, granting simply that the question chooses the method rather than the other way around; and (3) it reorients the critique: simply because a subfield considers itself to be problem-oriented does not mean that it is identifying the right problems to study. [ABSTRACT FROM AUTHOR]

During the Covid-19 pandemic and accompanying recession, millions of low-wage workers have become increasingly vulnerable to exploitation. Limited scholarly attention, however, has been paid to the relationship between rising unemployment, labour standards violations, and government enforcement capacities during periods of economic recession. In this article, we begin to draw out these connections. First, we turn to the case of the Great Recession of 2008-2010 in the United States to examine the relationship between rising unemployment and minimum wage violations, using Current Population Survey (CPS) data to estimate minimum wage violation rates by industry and demographic group. We find that minimum wage violations rose in tandem with rising unemployment, and were shouldered by some groups of low-wage workers more than others, and that they were unexpectedly affected certain industries more than others. We then use an analysis of internal complaint data filed with the San Francisco Office of Labour Standards Enforcement (OLSE) to illustrate that even during non-recession periods, the number of complaints received by industry are in some cases wildly disproportionate to the estimated violation rates by industry. This underscores the shortcomings of the complaint-based enforcement model, which is by far the most common mode of workplace regulation in the United States. Finally, we discuss how this empirical evidence points to the importance of developing alternatives to complaint-based models of enforcement - in particular, strategic enforcement and co-enforcement - especially during periods of high unemployment. [ABSTRACT FROM AUTHOR]

Since the 2016 election, President Trump has achieved unparalleled dominance over the Republican Party. He has also given his party a central role in his reelection campaign and invested heavily in its organizational capacities. This dual approach to party leadership – domination paired with organizational investment – bears a strong resemblance to the way every Republican president since Eisenhower interacted with his party, different only in degree. Where Trump's party leadership diverges qualitatively from past patterns is in its apparent purposes. Previous Republican presidents dominated and invested in their party for the explicit purpose of building a new majority in American politics. Reaching out to new demographic groups and trying to persuade them to join the party was integral to this project. Trump, in contrast, has (thus far) predominantly pursued a base-mobilization strategy. Rather than fan out horizontally in search of new groups to join the party coalition, Trump's strategy drills down vertically to penetrate and deepen his base. Instead of trying to diversify the GOP and extend its reach, his strategy aims to swell the number of like-minded supporters who are active in electoral and party politics (while suppressing, demobilizing, and delegitimizing the opposition party). By setting into motion a mutually reinforcing cycle of party domination and base mobilization, and amplifying its effects through organizational investment, Trump has turned his party into a formidable vehicle for advancing his personal purposes and augmenting his power – while raising troubling questions about the stability of American democracy. This article examines Trump's party leadership to date, compares it to previous presidential party leadership projects, and considers the implications. [ABSTRACT FROM AUTHOR]

In recent years, scholars have made major progress in understanding the dynamics of "policy drift"—the transformation of a policy's outcomes due to the failure to update its rules or structures to reflect changing circumstances. Drift is a ubiquitous mode of policy change in America's gridlock-prone polity, and its causes are now well understood. Yet surprisingly little attention has been paid to the political consequences of drift—to the ways in which drift, like the adoption of new policies, may generate its own feedback effects. In this article, we seek to fill this gap. We first outline a set of theoretical expectations about how drift should affect downstream politics. We then examine these dynamics in the context of four policy domains: labor law, health care, welfare, and disability insurance. In each, drift is revealed to be both mobilizing and constraining: While it increases demands for policy innovation, group adaptation, and new group formation, it also delimits the range of possible paths forward. These reactions to drift, in turn, generate new problems, cleavages, and interest alignments that alter subsequent political trajectories. Whether formal policy revision or further stalemate results, these processes reveal key mechanisms through which American politics and policy develop. [ABSTRACT FROM AUTHOR]

Over the past several decades, a new kind of labor politics has emerged in new venues (state and local levels), focusing on new governing institutions (employment laws), involving new strategies by labor unions, and featuring new organizational forms ("alt-labor"). The timing, form, and content of these developments have been powerfully shaped by the persistence of the increasingly outmoded but still authoritative national labor law, which has constrained and channeled the efforts of workers and their advocates to respond to growing problems. While the new institutions and organizations provide new substantive rights for workers and alternative vehicles for voice and collective action, the layering of these new forms alongside the old—without displacing the latter—has generated new problems without solving the problems produced by the ossification of labor law in the first place. Using novel empirical data and analysis, this article documents these changes, explores their causes, and considers their consequences for the changing politics of workers' rights. [ABSTRACT FROM AUTHOR]

Introduction Traumatic pancreatic injuries are rare, and morbidity and mortality information are often conflicting. To determine the frequency and outcomes of patients presenting with trauma to the pancreas, we reviewed data from a large multi-institutional healthcare system for mechanism of injury, intervention, subsequent complications, in-hospital morbidity rates, and mortality. Methods We performed a retrospective analysis of records of all pancreatic injury cases seen at four healthcare centers from 1990 to 2014. Descriptive measures are presented for continuous and categorical data. Mortality rates were obtained using the publicly accessible Social Security Death Master File. Results Of 69 patients with pancreatic injuries, median age was 24 years (range 1–88). Mechanisms of injury were blunt in 87% and penetrating in 11.8%. The median injury grade was 1. Most injuries involved the pancreatic head (24.6%). Median Injury Severity Score at presentation was 9. Thirty-seven (53.6%) patients required surgery. Twenty-five patients (36.2%) required total parenteral nutrition, 34 patients (49.3%) developed intra-abdominal fluid collections, 24 patients (34.8%) developed acute pancreatitis, and three (4.4%) developed endocrine insufficiency requiring insulin. Ten (14.5%) patients died. There were four (5.8%) readmissions and one re-operation (1.4%) within 30 days of discharge. Conclusion Traumatic pancreatic injuries occur most frequently in young healthy males with little or no comorbidities, and are generally associated with other acute injuries. Contrary to past reports, our results revealed a low mortality rate but significant morbidity, with the most common complications being intra-abdominal fluid collections, acute pancreatitis, and a need for total parenteral nutrition. [ABSTRACT FROM AUTHOR]

The article talks about the vast asymmetry of power in the workplace, an underlying cause of income inequality, that did not get discussed enough during the 2016 U.S. Presidential campaign. Topics discussed include the history of the imbalance between the rights of employees and the prerogatives of employers in the U.S., and the author's research on the enactment of state-level employment laws over several decades.

Institutional theorists have made major progress in recent years examining gradual processes of endogenous institutional change. Building on this line of theorizing, this article highlights an often overlooked source of incremental change in political institutions: investments in institutional resources. Unlike path-dependent processes, which are relatively open at the front end and relatively closed at the back end, resource investments made in one period serve to widen an institution's path and enhance its capacity to undertake a broader range of activities in subsequent periods. Drawn out over time, these investments can gradually transform institutional operations and purposes. To illustrate these dynamics, this article reconsiders the transformation of the national party committees into “parties in service” to their candidates. The most influential theoretical explanation for this change is supplied by actor-centered functionalist accounts that either ignore the parties' institutional forms or treat them as mere reflections of actors' preferences. As an alternative, I suggest that investments in two types of institutional resources—human resources and information assets—were integral to the process through which each party changed. Piecemeal investments in these resources gradually enabled each national party committee to provide a wider range of campaign services to its candidates, thereby producing ostensibly new “functions” over time. Though the process of institutional change unfolded at very different times in each party, the same dynamics were on display in both cases. [ABSTRACT FROM PUBLISHER]

Prior to 2004, Florida was one of seven states without its own minimum wage. In 2004, state voters overwhelmingly passed a ballot initiative that enshrined the right to a state minimum wage in Florida's Constitution. In 2020, voters passed a second ballot initiative that gradually raises Florida's minimum wage to $15 per hour. Despite bipartisan voter support, the Authors found that since 2004, the State has taken no formal actions to enforce Florida's minimum wage law. Further. the Authors' analysis of U.S. Census data demonstrated that amid the failure of State enforcement. minimum wage violations rose dramatically, disproportionately impacting women, Black, Latinx. and immigrant workers. Likewise, of the industries with the highest violation rates, five ofthe top six are key to Florida's economy. The Authors argue that Floridian workers need a state department of labor to fully realize the promise of Florida's constitutional right to the minimum wage. [ABSTRACT FROM AUTHOR]

A G5P2+2 woman in her 30s presented to hospital with per vaginum (PV) bleeding, approximately 2 weeks post electric vacuum aspiration (EVA) for retained products of conception. Ultrasound and MRI demonstrated a large vascular myometrial lesion, suggestive of a uterine arteriovenous malformation (UAVM). She underwent digital subtraction angiography (DSA) with interventional radiology and simultaneous uterine artery embolisation (UAE). She represented 2 weeks later with recurrent PV bleeding and anaemia. She underwent repeat DSA, demonstrating persistent UAVM, and a repeat embolisation was performed. Symptoms resolved following the second embolisation, and a repeat MRI performed 12 weeks later demonstrated complete resolution of the UAVM.Although UAVMs are rare lesions, they can cause significant haemorrhage and morbidity. The presence of UAVM should particularly be considered after uterine intervention such as EVA or caesarean section.UAE is a safe and effective therapy, which preserves fertility., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Traumatic pancreatic injuries are rare, and guidelines specifying management are controversial and difficult to apply in the acute clinical setting. Due to sparse data on these injuries, we carried out a retrospective review to determine outcomes following surgical or non-surgical management of traumatic pancreatic injuries. We hypothesize a higher morbidity and mortality rate in patients treated surgically when compared to patients treated non-surgically., Methods: We performed a retrospective review of data from four trauma centers in New York from 1990-2014, comparing patients who had blunt traumatic pancreatic injuries who were managed operatively to those managed non-operatively. We compared continuous variables using the Mann-Whitney U test and categorical variables using the chi-square and Fisher's exact tests. Univariate analysis was performed to determine the possible confounding factors associated with mortality in both treatment groups., Results: Twenty nine patients were managed operatively and 32 non-operatively. There was a significant difference between the operative and non-operative groups in median age (37.0 vs. 16.2 years, P  = 0.016), grade of pancreatic injury (grade I; 30.8 vs. 85.2%, P value for all comparisons <0.0001), median injury severity score (ISS) (16.0 vs. 4.0, P  = 0.002), blood transfusion (55.2 vs. 15.6%, P  = 0.0012), other abdominal injuries (79.3 vs. 38.7%, P  = 0.0014), pelvic fractures (17.2 vs. 0.00%, P  = 0.020), intensive care unit (ICU) admission (86.2 vs. 50.0%, P  = 0.003), median length of stay (LOS) (16.0 vs. 4.0 days, P <0.0001), and mortality (27.6 vs. 3.1%, P  = 0.010)., Conclusions: Patients with traumatic pancreatic injuries treated operatively were more severely injured and suffered greater complications than those treated non-operatively. The greater morbidity and mortality associated with these patients warrants further study to determine optimal triage strategies and which subset of patients is likely to benefit from surgery.