Objective We empirically demonstrate that the long‐held political distinction between the Deep South and the Peripheral South persists to this day. Methods Data from the Cooperative Congressional Election Study (CCES) are employed in logistic regression models to assess differences in the likelihood of voting Republican among Deep and Peripheral South whites in gubernatorial, senatorial, and presidential contests. Additionally, recent data on the partisan and racial composition of various elective offices document the sharp decline in Democratic officeholders. Results In contemporary Southern elections, Deep South whites, after controlling for several factors such as partisanship, ideology, religion, and income, are consistently and significantly more likely to vote Republican than their Peripheral South peers. Conclusions Race remains the most salient issue in Southern politics and it structures the alignment of whites and blacks into opposing parties. Because of this, whites are more Republican in their voting behavior in the more culturally conservative subregion where the proportion of African Americans is higher: the Deep South. Dixie is now dominated by the GOP, and especially in the Deep South, with grim representational implications for African Americans because they are no longer part of coalitional majorities at virtually every level of governance.
Over recent decades, the American states have implemented electoral reforms that make it easier for citizens to register and vote. This article examines the “equality effects” of these reforms: the degree to which reform serves to equalize or further skew participation rates between the rich and poor. Using the Voter Supplement to the Current Population Survey, the authors generate state-level estimates of income bias in registration and voting for elections from 1978 to 2008. Findings support their theory that some electoral reforms promote equality, while others further stratify the electorate—particularly when state registration rolls are already unrepresentative in terms of income groups.
ImportanceCerebral small vessel disease (SVD) causes a quarter of strokes and is the most common pathology underlying vascular cognitive impairment and dementia. An important step to developing new treatments is better trial methodology. Disease mechanisms in SVD differ from other stroke etiologies; therefore, treatments need to be evaluated in cohorts in which SVD has been well characterized. Furthermore, SVD itself can be caused by a number of different pathologies, the most common of which are arteriosclerosis and cerebral amyloid angiopathy. To date, there have been few sufficiently powered high-quality randomized clinical trials in SVD, and inconsistent trial methodology has made interpretation of some findings difficult.ObservationsTo address these issues and develop guidelines for optimizing design of clinical trials in SVD, the Framework for Clinical Trials in Cerebral Small Vessel Disease (FINESSE) was created under the auspices of the International Society of Vascular Behavioral and Cognitive Disorders. Experts in relevant aspects of SVD trial methodology were convened, and a structured Delphi consensus process was used to develop recommendations. Areas in which recommendations were developed included optimal choice of study populations, choice of clinical end points, use of brain imaging as a surrogate outcome measure, use of circulating biomarkers for participant selection and as surrogate markers, novel trial designs, and prioritization of therapeutic agents using genetic data via Mendelian randomization.Conclusions and RelevanceThe FINESSE provides recommendations for trial design in SVD for which there are currently few effective treatments. However, new insights into understanding disease pathogenesis, particularly from recent genetic studies, provide novel pathways that could be therapeutically targeted. In addition, whether other currently available cardiovascular interventions are specifically effective in SVD, as opposed to other subtypes of stroke, remains uncertain. FINESSE provides a framework for design of trials examining such therapeutic approaches.
Expansive and restrictive state electoral institutions have been instrumental in structuring the vote throughout American history. Studies focused on a small number of reforms, years, or states lack the scope necessary to comprehensively evaluate the effects of institutional change over time. This work, however, places recent reforms in historical context and offers a long-term perspective. Using an original data set, it identifies the institutions that have generated the most substantial effects on state turnout rates during presidential elections from 1920 to 2000. Findings demonstrate that restrictive laws (those aiming to limit the vote or make voting more costly) produced large and consistently negative effects in the Southern and non-Southern states alike, but the effects associated with expansive reforms (those making participation more convenient or less costly) vary. Although a few expansive laws have increased turnout in the non-Southern states, they have had no effect in the Southern states where turnout rates are lowest.
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