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In this research note, we investigate the degree to which local governments reduced or expanded the budgets of police departments in the aftermath of the nation-wide protests organized by the Black Lives Matter movement during the summer of 2020. We also consider the political and social factors that might explain local councils' decisions on the budget. In analyzing an original dataset of about 100 of the most populous U.S. cities, we do not find strong evidence of government efforts to "defund" the police. However, across various specifications of potential responsiveness to the movement's demands, we do find that mayoral partisanship may be associated with local government decisions to meaningfully reduce their police budgets or abstain from increasing them, but even this relationship may not be sustained in the longer term. Thus, we encourage more research on barriers that potentially inhibit local government responsiveness to social movements like Black Lives Matter. [ABSTRACT FROM AUTHOR]

Obesity is associated with respiratory dysfunction. It is a key risk and contributory factor in the sleep related breathing disorders, obstructive sleep apnoea/hypopnoea syndrome (OSAHS) and obesity hypoventilation syndrome (OHS). Weight management is an integral part of the management of these disorders, in addition to continuous positive airways pressure (CPAP) and non-invasive ventilation (NIV). Untreated, these conditions are associated with a high disease burden and as treatment is effective, early recognition and referral is critical. Best practice in on-going care is multidisciplinary. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Concerns have repeatedly been raised about end‐of‐life decision making when a patient with diminished capacity is represented by a professional guardian, a paid official appointed by a judge. Such guardians are said to choose high‐intensity treatment even when it is unlikely to be beneficial or to leave pivotal decisions to the court. End‐of‐life decision making by professional guardians has not been examined systematically, however. DESIGN: Retrospective cohort study. SETTING: Inpatient and outpatient facilities in the Department of Veterans Affairs (VA) Connecticut Healthcare System. PARTICIPANTS: Decedent patients represented by professional guardians who received care at Connecticut VA facilities from 2003 to 2013 and whose care in the last month of life was documented in the VA record. MEASUREMENTS: Through chart reviews, we collected data about the guardianship appointment, the patient's preferences, the guardian's decision‐making process, and treatment outcomes. RESULTS: There were 33 patients with professional guardians who died and had documentation of their end‐of‐life care. The guardian sought judicial review for 33%, and there were delays in decision making for 42%. In the last month of life, 29% of patients were admitted to the intensive care unit, intubated, or underwent cardiopulmonary resuscitation; 45% received hospice care. Judicial review and high‐intensity treatment were less common when information about the patient's preferences was available. CONCLUSION: Rates of high‐intensity treatment and hospice care were similar to older adults overall. Because high‐intensity treatment was less likely when the guardian had information about a patient's preferences, future work should focus on advance care planning for individuals without an appropriate surrogate. J Am Geriatr Soc 67:2161–2166, 2019 [ABSTRACT FROM AUTHOR]

Endorsements have become a part of most election cycles. They come from a variety of sources (civic organizations, elected officials, newspapers, etc.) and are intended to signal voters that one candidate is preferential to another. Yet, there is still a lot that we do not know about endorsements. In this article, we provide insight into the process of how organizations and newspapers endorse candidates, provide evidence that demonstrates candidates believe these endorsements are important, and test the claim that voters are aware of these endorsements even when controlling for factors such as partisanship, ideology, and education. We also test the claim that issue positions explain vote choice better than endorsements. We rely on interview data and exit poll data to test our claims. Using data from an at-large municipal election, in which voters selected up to three candidates, we find that awareness of endorsements explains vote choice better than issues. [ABSTRACT FROM AUTHOR]

Black and Latino voters support coethnic candidates at high rates in local elections. What is less clear is how Black and Latino voters respond to out-group candidates when they do not have the option to support a coethnic candidate. I posit that when race and ethnicity become salient in a campaign, endorsements from Black and Latino leaders and organizations increase support of out-group candidates among Blacks and Latinos. I find that this hypothesis is strongly supported among Blacks. However, the same is not true for Latinos, most likely because of the political heterogeneity of the group. Using data from a survey experiment, I show that Black endorsements of minority out-group candidates are persuasive for Blacks, while comparable endorsements from Latinos are not as influential among Latinos. [ABSTRACT FROM AUTHOR]

Ethnographies of gentrification, by using interviews, suggest individual and group sentiments about it as a form of revitalisation are heterogenous, even within neighbourhoods experiencing it. Discerning variation and changes over time in citywide sentiments about gentrification, however, is a challenge. It requires city-level survey data, especially longitudinal data, which is scarce. We use novel data from Washington Post surveys of District of Columbia (i.e. Washington, DC) residents between 2000 and 2016 to test predictions of city-level gentrification opinions, deduced from neighbourhood-based ethnographies of gentrification. We observe and emphasise how, over time, race is consistently associated with opinion divergence about gentrification, including perceptions of its inequalities and consequences. Our findings demonstrate the value of citywide surveys for extending empirical findings from neighbourhood-level ethnographies of gentrification. [ABSTRACT FROM AUTHOR]

Background: Evaluating infection in home‐based primary care is challenging, and these challenges may impact antibiotic prescribing. A refined understanding of antibiotic decision‐making in this setting can inform strategies to promote antibiotic stewardship. This study investigated antibiotic decision‐making by exploring the perspectives of clinicians in home‐based primary care. Methods: Clinicians from the Department of Veterans Affairs Home‐Based Primary Care Program were recruited. Semi‐structured interviews were conducted from June 2022 through September 2022 using a discussion guide. Transcripts were analyzed using grounded theory. The constant comparative method was used to develop a coding structure and to identify themes. Results: Theoretical saturation was reached after 22 clinicians (physicians, n = 7; physician assistants, n = 2, advanced practice registered nurses, n = 13) from 19 programs were interviewed. Mean age was 48.5 ± 9.3 years, 91% were female, and 59% had ≥6 years of experience in home‐based primary care. Participants reported uncertainty about the diagnosis of infection due to the characteristics of homebound patients (atypical presentations of disease, presence of multiple chronic conditions, presence of cognitive impairment) and the challenges of delivering medical care in the home (limited access to diagnostic testing, suboptimal quality of microbiological specimens, barriers to establishing remote access to the electronic health record). When faced with diagnostic uncertainty about infection, participants described many factors that influenced the decision to prescribe antibiotics, including those that promoted prescribing (desire to avoid hospitalization, pressure from caregivers, unreliable plans for follow‐up) and those that inhibited prescribing (perceptions of antibiotic‐associated harms, willingness to trial non‐pharmacological interventions first, presence of caregivers who were trusted by clinicians to monitor symptoms). Conclusions: Clinicians face the difficult task of balancing diagnostic uncertainty with many competing considerations during the treatment of infection in home‐based primary care. Recognizing these issues provides insight into strategies to promote antibiotic stewardship in home care settings. [ABSTRACT FROM AUTHOR]

The article presents advice and information for junior doctors who are unfamiliar with performing a clinical medical audit of medical care which measures medical practice against medical standards in an effort to determine the quality of provided medical care. A discussion of the factors which an audit can assess, including the structure of care and the outcome of care, is presented. A discussion of research which has examined the effectiveness of audits is presented. Different types of audits which are used in medicine are discussed. INSET: Worked example: how to perform the perfect audit.

Researchers have argued that explicit racial appeals are rejected in contemporary American politics because they are perceived as violating the norm of racial equality. We test this claim with an experimental design, embedded in a representative survey of Georgia where, until recently, the state flag featured the Confederate battle emblem. In our experiment, we manipulate the salience of racial cues in news accounts of the state flag controversy in Georgia. We hypothesize that women are more likely than men to reject explicit racial appeals. We focus on the effects of explicit messages in two areas: support for Confederate symbols and identification with the Democratic Party. As hypothesized, when the racial significance of this debate is made explicit support for the Confederate flag declines, but only among women. Similarly, explicit appeals lead to lower levels of Democratic identification among men, but among women the effects are weaker and less consistent. [ABSTRACT FROM AUTHOR]