Political partisanship, laissez-faire attitudes, and COVID-19 behaviours and viewpoints in Canada and the United States.

OBJECTIVE: In the United States, clear partisan differences in responses to COVID-19 have been shown in leadership and elite cueing at the state level as well as in perspectives and behaviours of the citizenry. This study probes differences in political values-particularly the prevalence of laissez-faire attitudes-that might explain the stronger social consensus on pandemic countermeasures seen in Canada. METHODS: Data were obtained from temporally aligned waves of cross-sectional surveys of Canadian and US adults in the first year of the pandemic. Survey questions were used to construct an index of laissez-faire attitudes (LFA) which, along with demographic variables and measures of partisanship, was incorporated into regression models to predict three outcomes: practice of personal mitigation measures (e.g. mask wearing), level of worry about the pandemic, and likeliness to get a vaccine. RESULTS: LFA scores had a strong negative relationship to all three outcomes for Canadians and Americans, albeit with larger effects among the Americans on two outcomes. Overall differences in LFA scores between Americans and Canadians were modest (0.04 on a 0-1 scale). However, Republican Party stalwarts had considerably higher LFA scores and were proportionally more numerous than Conservative loyalists in Canada. While there were partisan differences in LFA scores within Canada, the largest gap by far was between Republicans and Democrats in the USA. Respondents from Canada's Prairie provinces had slightly higher average LFA scores but there were no significant residence effects on outcomes. CONCLUSION: Laissez-faire attitudes that may conflict with public health values and measures are much more prevalent in the USA than in Canada. This difference underpins the limited effects of political partisanship and broad consensus in the Canadian public's responses to the pandemic.

RéSUMé: OBJECTIF: Aux États-Unis, des différences partisanes évidentes au niveau des réactions face au COVID-19 ont été mises en évidence pour ce qui est du leadership et des indications données par l'élite au niveau de l'État, ainsi que des perspectives et des comportements des citoyens. Cette étude examine les différences de valeurs politiques, en particulier la prévalence de comportements de type « laissez-faire ¼, susceptibles d'expliquer le consensus social plus fort observé au Canada concernant les contre-mesures à prendre en cas de pandémie. MéTHODES: Les données ont été obtenues à partir de séries d'enquêtes transversales alignées temporellement auprès d'adultes canadiens et américains durant la première année de la pandémie. Les questions de l'enquête ont été utilisées pour élaborer un indice de laissez-faire (LFA) qui, avec des variables démographiques et des indicateurs de partisanerie, a été incorporé dans des modèles de régression pour prédire trois résultats : la mise en œuvre de mesures d'atténuation personnelles (par exemple, le port d'un masque), le niveau d'inquiétude face à la pandémie et la probabilité de se faire vacciner. RéSULTATS: Les scores LFA ont une forte relation négative avec les trois résultats pour les Canadiens et les Américains, bien qu'avec des effets plus importants chez les Américains pour deux résultats. Les différences globales dans les scores LFA entre les Américains et les Canadiens étaient modestes (0,04 sur une échelle de 0 à 1). Toutefois, les fervents du parti républicain ont obtenu des scores nettement plus élevés au niveau du LFA et étaient proportionnellement plus nombreux que les partisans du parti conservateur au Canada. S'il existe des différences partisanes dans les scores du LFA au sein du Canada, l'écart le plus important, et de loin, se situe entre les républicains et les démocrates aux États-Unis. Les répondants des provinces des Prairies au Canada ont obtenu des scores moyens légèrement plus élevés pour le LFA, mais il n'y a pas eu d'effets significatifs du lieu de résidence sur les résultats. CONCLUSION: Les attitudes de « laissez-faire ¼ pouvant entrer en conflit avec les valeurs et les mesures de santé publique sont beaucoup plus répandues aux États-Unis qu'au Canada. Cette différence explique les effets limités de la partisanerie politique et du consensus général quant aux réactions du public canadien face à la pandémie.

Case Report: What-or who-killed Frank Ramsey? Some reflections on cause of death and the nature of medical reasoning.

Philosopher Frank Ramsey died in 1930 aged only 26. There has been much speculation about the nature of his final illness and the sequence of events which led to his death. To prepare this case report, we traced Ramsey's medical records and combined them with an extensive and unique dataset of contemporaneous sources. We use these to evaluate three possible explanations for Ramsey's illness and its unexpectedly fatal trajectory-infectious (Weil's disease), autoimmune (primary sclerosing cholangitis) and obstructive (gallstones). We explore how uncertainty surrounding each of these possibilities might have influenced Ramsey's doctors' thoughts and actions, including their ill-fated decision to perform the emergency operation that appears to have precipitated his final decline. We then reflect on the unfinished opus on which Ramsey was working when he died-on the nature of truth and how humans reason under conditions of uncertainty. We end with some thoughts linking Ramsey's death to his philosophy.

The small hydrophobic (SH) gene of North American turkey AMPV-C does not attenuate nor modify host tropism in recombinant European duck AMPV-C.

Subgroup C Avian Metapneumoviruses (AMPV-C) has two lineages, one mostly in turkeys and one mostly in ducks. To investigate the molecular basis of AMPV-C host tropism, a reverse genetics system for a duck AMPV-C virus was developed. A recombinant copy and a recombinant virus in which the SH protein had been exchanged for that of a turkey AMPV-C were rescued. No change in cytopathogenic effect or replication profile in vitro were observed for either virus compared to the wild type. In SPF Muscovy ducks the wild type and its recombinant copy were equally pathogenic. Exchanging the SH in the recombinant copy produced the same results. In SPF turkeys, neither recombinant virus was pathogenic, although both showed a low level of replication. Thus, from the current model, it appears that AMPV-C SH proteins derived from the different species are compatible and that turkey SH does not affect duck AMPV-C pathogenicity.

Variation in clinical practice: forests and trees revisited.

Variations in clinical practice are commonly viewed as a sign of uneven quality of care and attributed to provider self-interest. However, patient preferences, physician practice patterns, and diagnostic and therapeutic uncertainty also cause variations. Greater attention to both doctor-patient interactions and limits to the available evidence might enable more effective assessment and improvement of health-care quality.

Clostridium perfringensα-toxin interaction with red cells and model membranes.

The effects of Clostridium perfringensα-toxin on host cells have previously been studied extensively but the biophysical processes associated with toxicity are poorly understood. The work reported here shows that the initial interaction between the toxin and lipid membrane leads to measurable changes in the physical properties and morphology of the membrane. A Langmuir monolayer technique was used to assess the response of different lipid species to toxin. Sphingomyelin and unsaturated phosphatidylcholine showed the highest susceptibility to toxin lypolitic action, with a two stage response to the toxin (an initial, rapid hydrolysis stage followed by the insertion and/or reorganisation of material in the monolayer). Fluorescence confocal microscopy on unsaturated phosphatidylcholine vesicles shows that the toxin initially aggregates at discrete sites followed by the formation of localised "droplets" accumulating the hydrolysis products. This process is accompanied by local increases in the membrane dipole potential by about 50 (±42) mV. In contrast, red blood cells incubated with the toxin suffered a decrease of the membrane dipole potential by 50 (±40) mV in areas of high toxin activity (equivalent to a change in electric field strength of 10(7) V m(-1)) which is sufficient to affect the functioning of the cell membrane. Changes in erythrocyte morphology caused by the toxin are presented, and the early stages of interaction between toxin and membrane are characterised using thermal shape fluctuation analysis of red cells which revealed two distinct regimes of membrane-toxin interaction.