Are political-opinion pollsters missing ambivalence: "I love Trump" "I hate Trump".

Given the increasing attention ambivalence is receiving from the psychological community, it must be asked if pollsters' (routinely) dichotomous political opinion surveys are missing something crucial. To determine if there is any legitimacy to this question, undergraduates attending a Liberal Arts college in Southern California were asked to rate their level of agreement/disagreement to 28 statements regarding President Trump in two studies, with the items drawn from actual Quinnipiac (Q) and Brookings Institute (BI) surveys. To quantify ambivalence participants were told they could mark one or two responses per item, with double-responses serving as a measure of ambivalence. In Study 1, mean Trump approval ratings divided along party lines, and were consistent with the Q and BI findings. Nonetheless, approximately 40% of participants registered some level of ambivalence across all political-party affiliations, with those defining themselves as Neither Democrats (DEMs) nor Republicans (REPs) showing the greatest degree of ambivalence. In Study 2, ambivalence towards President Trump was examined looking at both party affiliation and political ideology (Conservative, Moderate, and Liberal). Again, roughly 40% of participants displayed some level of ambivalence, with greater degrees of ambivalence for Independents relative to DEMs and REPs, and Moderates relative to Liberals. Given research indicating that ambivalence is associated with delayed decision making and decisions based on "in the moment" contextual information, our findings our suggestive: if political opinion pollsters do not assess ambivalence, they may be missing information on a fair-sized demographic that could influence an election based on negative information (real or fictitious) surfacing only days before an election… as it did in 2016.

Association of Pharmacist Prescription of Hormonal Contraception With Unintended Pregnancies and Medicaid Costs.

OBJECTIVE: To estimate unintended pregnancies averted and the cost effectiveness of pharmacist prescription of hormonal contraception. METHODS: A decision-analytic model was developed to determine the cost effectiveness of expanding the scope of pharmacists to prescribe hormonal contraception compared with the standard of care and contraceptive access in clinics. Our perspective was that of the payor, Oregon Medicaid. Our primary outcome was unintended pregnancies averted. Secondary outcomes included: costs and quality-adjusted life years (QALYs). Model inputs were obtained from an analysis of Medicaid claims for the first 24 months after policy implementation in Oregon, and the literature. Univariate and bivariate sensitivity analyses, as well as a Monte Carlo simulation, were performed. RESULTS: Among Oregon's Medicaid population at risk for unintended pregnancy, the policy expanding the scope of pharmacists to prescribe hormonal contraception averted an estimated 51 unintended pregnancies and saved $1.6 million dollars. Quality of life was also improved, with 158 QALYs gained per 198,000 women. Sensitivity analysis demonstrated that the model was most sensitive to the effect on contraceptive continuation rates. If contraceptive continuation rates among women receiving care from a pharmacist are 10% less than among clinicians, than pharmacist prescription of hormonal contraception will not avert unintended pregnancies. CONCLUSION: Pharmacist prescription of hormonal contraception averts unintended pregnancies and is cost effective. Full implementation of the policy is needed for maximum benefits. Prospective data on the effect of the policy on contraceptive continuation rates are needed.

Pharmacists expand access to reproductive heaLthcare: PEARL study protocol.

BACKGROUND: In 2016, Oregon became the first of eight states to allow pharmacists to directly prescribe hormonal contraception (HC), including the pill, patch, or ring, without a clinic visit. In the two years following this policy change, the majority of ZIP codes across the state of Oregon had a pharmacist certified to prescribe HC. METHODS: We will utilize complementary methodologies to evaluate the effect of this policy change on convenient access to contraception (cost, supply dispensed), safety, contraceptive continuation and unintended pregnancy rates. We will conduct a prospective clinical cohort study to directly measure the impact of provider type on contraceptive continuation and to understand who is accessing hormonal contraception directly from pharmacists. We will concurrently conduct a retrospective analysis using medical claims data to evaluate the state-level effect of the policy. We will examine contraceptive continuation rates, incident pregnancy, and safety measures. The combination of these methodologies allows us to examine key woman-level factors, such as pregnancy intention and usual place of care, while also estimating the impact of the pharmacist prescription policy at the state level. DISCUSSION: Pharmacist prescription of HC is emerging nationally as a strategy to reduce unintended pregnancy. This study will provide data on the effect of this practice on convenient access to care, contraceptive safety and continuation rates.

Being of "two minds": Assessing vacillating and simultaneous ambivalence with the density matrix.

Ambivalence is a common experience that permeates a broad range of research. Unfortunately, quantifying ambivalence has proven a daunting task, with researchers limited to studying vacillating ambivalence, VA (i.e., temporal oscillations between favor/disfavor evaluations of an attitude object). Here, we demonstrate the use of the density matrix to measure both VA and what we term "simultaneous ambivalence" (SA): ambivalence that manifests itself as "in the moment" concurrent favor/disfavor evaluations. In a methodological study we gave participants the option of either single-responding or double-responding to questionnaire items regarding a controversial topic (i.e., affirmative action). Since standard statistical procedures provide no means for analyzing double responses, such data are routinely treated as "bad." As demonstrated here, the density matrix provides an unambiguous and relatively easy means of accounting for double responses, which is our indicator of SA. Our data are well explained by a mixture model, with participants divided into two nearly equal groups of SA and non-SA participants, and provide evidence that the general phenomenon of SA transcends differences of gender and ethnicity. Further, the density matrix data are consistent with viewing SA and VA as distinct ambivalence constructs.

The epidemiology of end stage renal disease at a centre in Trinidad.

OBJECTIVE: The aim of this study is to estimate the trends in prevalence of end stage renal disease (ESRD) during the period 1999-2007 at one site in Trinidad, the Eric Williams Medical Sciences Complex (EWMSC), and to describe the epidemiological features, age, gender, ethnicity and comorbidities associated with ESRD. DESIGN AND METHODS: A retrospective cohort study design was used. There was a count of patients on haemodialysis at the EWMSC centre from 1999-2007 in order to demonstrate trends in prevalence but more detailed data were collected and analysed for patients with ESRD attending the nephrology clinic between January 2002 and December 2007. The data that were collected from the patients' records included: demographic data (age, gender and ethnicity), medical history (diabetes mellitus, hypertension, end stage renal disease and autoimmune disorders), history of dialysis (type of vascular access, frequency of dialysis), mortality and its cause. RESULTS: Records of 81 patients were retrieved. Their age range was 10-79 years. The survey showed that patients most affected in the study population were: males, aged 50-59 years, who were hypertensive and/or diabetic and of African descent. CONCLUSIONS: In conclusion, we provide epidemiological evidence of ESRD and the associated contributing factors at one hospital in Trinidad.

Interviewing children in custody cases: implications of research and policy for practice.

Research on child interviewing has burgeoned over the past 25 years as expectations about children's agency, competence, and participation in society have changed. This article identifies recent trends in research, policy, and theory with implications for the practice of interviewing children in cases of contested divorce and for the weight to be given the information children provide. A number of fields of relevant research are identified, including studies of families who have participated in the family law system, studies of child witnesses in the field, experimental studies of the effects of interview techniques on children's memory and suggestibility, and ethnographic methods that elicit children's views of their own experiences. Finally, a set of 10 principles for practice are delineated based on the best available science.