The voting experience and beliefs about ballot secrecy.

New democracies go to great lengths to implement institutional protections of the electoral process. However, in this paper we present evidence that shows that even in the United States-where the secret ballot has been in place for generations-doubts about the secrecy of the voting process are surprisingly prevalent. Many say that their cast ballot can be matched to their name or that others could observe their vote choices while they were voting. We find that people who have not previously voted are particularly likely to harbor doubts about the secrecy of voters' ballots. Those who vote by mail in the privacy of their own homes also feel that others are able to discover their vote choices. Taken together, these findings suggest an important divergence between public perceptions about and the institutional status of the secret ballot in the United States, a divergence that may affect patterns of voting behavior and political participation.

Validation and Testing of Fast Healthcare Interoperability Resources Standards Compliance: Data Analysis.

BACKGROUND: There is wide recognition that the lack of health data interoperability has significant impacts. Traditionally, health data standards are complex and test-driven methods played important roles in achieving interoperability. The Health Level Seven International (HL7) standard Fast Healthcare Interoperability Resources (FHIR) may be a technical solution that aligns with policy, but systems need to be validated and tested. OBJECTIVE: Our objective is to explore the question of whether or not the regular use of validation and testing tools improves server compliance with the HL7 FHIR specification. METHODS: We used two independent validation and testing tools, Crucible and Touchstone, and analyzed the usage and result data to determine their impact on server compliance with the HL7 FHIR specification. RESULTS: The use of validation and testing tools such as Crucible and Touchstone are strongly correlated with increased compliance and "practice makes perfect." Frequent and thorough testing has clear implications for health data interoperability. Additional data analysis reveals trends over time with respect to vendors, use cases, and FHIR versions. CONCLUSIONS: Validation and testing tools can aid in the transition to an interoperable health care infrastructure. Developers that use testing and validation tools tend to produce more compliant FHIR implementations. When it comes to health data interoperability, "practice makes perfect."

Doctor knows best: physician endorsements, public opinion, and the politics of comparative effectiveness research.

The Obama administration has made a major investment in comparative effectiveness research (CER) to learn what treatments work best for which patients. CER has the potential to reduce wasteful medical spending and improve patient outcomes, but the political sustainability of this initiative remains unclear because of concerns that it will threaten the doctor-patient relationship. An unresolved question is whether it is possible to boost public support for the use of CER as a cost-control strategy. We investigate one potential source of public support: Americans' trust in physicians as faithful agents of patient interests. We conducted two national surveys to explore the public's confidence in doctors compared to other groups. We find that doctors are viewed as harder workers, more trustworthy, and more caring than other professionals. Through survey experiments, we demonstrate that the support of doctors' groups for proposals to control costs and use CER have a greater influence on aggregate public opinion than do cues from political actors including congressional Democrats, Republicans, and a bipartisan commission. Our survey results suggest that the medical profession's stance will be an important factor in shaping the political viability of efforts to use CER as a tool for health care cost control.

The public wants information, not board mandates, from comparative effectiveness research.

We conducted two national surveys of public opinion about comparative effectiveness research and the integration of findings from the research into clinical practice. The first survey found broad support for using research results to provide information, but less support for using them to allocate government resources or mandate treatment decisions. In addition, the public is willing to consider the use of financial incentives to encourage patients to choose cheaper treatments, if research demonstrates that they work as well as more expensive ones. The second survey found that support for comparative effectiveness research dropped in response to general debates about its consequences but that arguments against the research could be effectively countered by specific, targeted rebuttals.

A national survey reveals public skepticism about research-based treatment guidelines.

Using research to develop treatment guidelines is one way to lower medical costs and improve care. However, findings from a national survey show that the public is skeptical about this approach. Specifically, the public finds arguments against establishing research-based treatment guidelines more convincing than arguments in favor of it. Our findings suggest that for evidence-based treatment guidelines to win public acceptance, the public needs to be reassured that guidelines would not lead to the limiting of access to beneficial care.

Bis(pyrazolylethyl) Ether Ligation to Zinc and Cobalt: Meridional vs Facial Coordination and the Suitability of Such Ligands in Providing a NNO Donor Set for Modeling Bioinorganic Aspects of Zinc Chemistry.

The structures of bis(pyrazolylethyl) ether derivatives of zinc and cobalt, namely [eta(3)-O(CH(2)CH(2)pz(Pr)()i()2)(2)]Zn(NO(3))(2) and [eta(3)-O(CH(2)CH(2)pz(Me)()2)(2)]Co(NO(3))(2), have been determined with a view to addressing the applicability of such ligands in modeling bioinorganic aspects of zinc chemistry. Specific consideration is given to the possibility that bis(pyrazolylethyl) ether ligands may provide an NNO donor system which may model aspects of the binding of zinc to protein backbones in enzymes such as thermolysin. The structural studies demonstrate that the bis(pyrazolylethyl) ether ligands do indeed coordinate via each of their NNO functionalities but that the relationship to the enzyme is limited by the adoption of meridional rather than facial coordination geometries. [eta(3)-O(CH(2)CH(2)pz(Pr)()i()2)(2)]Zn(NO(3))(2) is monoclinic, P2(1)/c (No. 14), with a = 11.619(2) Å, b = 14.380(3) Å, c = 16.757(2) Å, beta = 90.44(2) degrees, and Z = 4. [eta(3)-O(CH(2)CH(2)pz(Me)()2)(2)]Co(NO(3))(2) is monoclinic, C2/c (No. 15), with a = 17.136(3) Å, b = 10.505(2) Å, c = 11.121(2) Å, beta = 104.62(3) degrees, and Z = 4.