Michael J. Ensley

Who Fits the Left-Right Divide? Partisan Polarization in the American Electorate

How has the American public responded to elite partisan polarization? Using panel data from both the Cooperative Campaign Analysis Project and the American National Election Studies, we explore the partisan consequences of the discrepancy between the one-dimensional structure of elite policy preferences and the two-dimensional structure of citizens’ policy preferences. We find that those citizens with preferences that are consistently liberal or consistently conservative across both economic and social issues have responded to elite polarization with mass polarization. However, we also find that the sizable number of citizens who hold preferences on economic and social issues that do not perfectly match the menu of options provided by elite Republicans and Democrats have not responded to elite polarization; indeed, these citizens are more likely to shift their partisan allegiance in the short-term and less likely to strengthen their party identification in the long term.

Candidate Divergence, Ideology, and Vote Choice in U.S. Senate Elections

Although it has been long established that ideology influences the decisions of American voters, scholars have begun more recently to delineate which voters under what conditions will vote ideologically. Although these studies have been illuminating, most analyses have failed to account for one critical contextual factor: candidate ideological divergence. Using a random-effects probit model and data from the 1988 to 1992 American Senate Election Studies, I show that the ideological divergence among Senate candidates conditions the influence of ideology on vote choice, at least among the more politically knowledgeable segment of the population. This reinforces and extends the findings of Wright and Berkman that ideologically polarized candidates produce ideological voters.

Political Ideology in American Politics: One, Two, or None?

Abstract Are Americans ideological, and if so, what are the foundations of their ideology? According to Converse’s seminal view, whatever the case in other western democracies and despite its centrality to traditional versions of textbook democracy, the American public is distinctly non-ideological. Our objective is to compare the standard and by far most widely used measure of political ideology—a measure that presumes ideology is one-dimensional—to a more recent measure that allows for a multi-dimensional conception and measurement. This measure demonstrates that while American political elites compete across a single dimension of conflict, the American people organize their policy attitudes around two distinct dimensions, one economic and one social. After explaining how we derived the measure and how it can be used to develop five separate ideological groups, we show how these groups differ politically and why it is not possible to map their preferences onto a one-dimensional measure of ideology.

Do Candidate Positions Matter?: The Effect of the Gay Marriage Question on Gubernatorial Elections

This article demonstrates that candidate positions on the ballot measure to ban gay marriage had an effect on gubernatorial voting. With exit poll data from three states in 2006, we find that the effect of support for the ban is at least twice as large when the candidates adopted divergent positions. Support for the ban has a smaller but significant effect on vote choice when the candidate positions converge, which suggests an indiscriminate priming effect. These findings are supported with aggregate data from 45 gubernatorial races in 2004 and 2006. The analysis reveals that Republican candidates benefited if candidate positions diverged, with the Democratic candidates expressing opposition to the gay marriage ban.

Atypical Hemolytic Uremic Syndrome: A Meta-Analysis of Case Reports Confirms the Prevalence of Genetic Mutations and the Shift of Treatment Regimens: Meta-Analysis of Atypical HUS Case Reports

Atypical hemolytic uremic syndrome (aHUS) is a rare life‐threatening thrombotic microangiopathy (TMA) affecting multiple organ systems. Recently, aHUS has been shown to be associated with uncontrolled complement activation due to mutations in the alternative pathway of complement components paving the way for targeted drug therapy. By meta‐analysis of case reports, we discuss the impact of new treatment strategies on the resolution time of aHUS symptoms and mortality, and the distribution of genetic mutations. A PubMed/Medline search was conducted for “atypical hemolytic uremic syndrome” case reports published between November 2005 and November 2015. R Version 3.2.2 was used to calculate descriptive statistics and perform univariate analyses. Wilcoxon rank‐sum test was used to compare time to symptoms resolution, creatinine and platelet count normalization across the treatment and mutation carrier groups. A total of 259 aHUS patients were reported in 176 articles between 2005 and 2015. In the last 5‐year period compared to the precedent, there was an increase in the number of aHUS cases reported (180 vs. 79 cases) and the use of eculizumab also increased (6.3% to 46.1%, P < 0.000), although plasma exchange usage did not change (P = 0.281). CFH antibodies were present in a significantly higher number of patients treated with plasma exchange therapy (19.1%, P = 0.000) while none of the non‐plasma exchange therapy group had CFH antibodies. Most common mutation was CFH (50%, 69/139) followed by CFHR1 (35%, 30/85), MCP (22.8%, 23/101) and CFI (16.6%, 17/102). Time to symptoms resolution and serum creatinine or platelet count normalization were not significantly different between eculizumab and non‐eculizumab group (P = 0.166, P = 0.361, P = 0.834), and between plasma exchange and non‐plasma exchange group (P = 0.150, P = 0.135, P = 0.784). However, both eculizumab and plasma exchange groups had early platelet recovery (22 vs. 30 days and 25.5 vs. 32.5 days), faster creatinine normalization (27 vs. 30.5 days and 27 vs. 37 days) and interestingly, a longer period for symptoms resolution (45.5 vs. 21 days and 30 vs. 18.5 days) compared to non‐eculizumab and non‐plasma exchange groups. Mortality rate decreased with the use of eculizumab significantly (P = 0.045) compared to non‐eculizumab group and there was no change in mortality rate with the use of plasma exchange therapy (P = 0.760) compared to non‐plasma exchange group. Plasma exchange continues to be the initial treatment of choice for aHUS. Although significant reduction in the mortality rate was noted with the use of eculizumab, there were no differences in time to resolution of symptoms or serum creatinine or platelet normalization with the use of either eculizumab or plasma therapy. Atypical HUS is acute and life‐threatening, so plasma exchange may be initiated before the confirmed diagnosis and in patients positive for CFH antibodies. Eculizumab therapy should be considered once aHUS is confirmed by genetic testing.

Treatment of AKI in developing and developed countries: An international survey of pediatric dialysis modalities

Hypothesis Acute kidney injury (AKI) is a common cause of morbidity and mortality worldwide, with a pediatric incidence ranging from 19.3% to 24.1%. Treatment of pediatric AKI is a source of debate in varying geographical regions. Currently CRRT is the treatment for pediatric AKI, but limitations due to cost and accessibility force use of adult equipment and other therapeutic options such as peritoneal dialysis (PD) and hemodialysis (HD). It was hypothesized that more cost-effective measures would likely be used in developing countries due to lesser resource availability. Methods A 26-question internet-based survey was distributed to 650 pediatric Nephrologists. There was a response rate of 34.3% (223 responses). The survey was distributed via pedneph and pcrrt email servers, inquiring about demographics, technology, resources, pediatric-specific supplies, and preference in renal replacement therapy (RRT) in pediatric AKI. The main method of analysis was to compare responses about treatments between nephrologists in developed countries and nephrologists in developing countries using difference-of-proportions tests. Results PD was available in all centers surveyed, while HD was available in 85.1% and 54.1% (p = 0.00), CRRT was available in 60% and 33.3% (p = 0.001), and SLED was available in 20% and 25% (p = 0.45) centers of developed and developing world respectively. In developing countries, 68.5% (p = 0.000) of physicians preferred PD to costlier therapies, while in developed countries it was found that physicians favored HD (72%, p = 0.00) or CRRT (24%, p = 0.041) in infants. Conclusions Lack of availability of resources, trained physicians and funds often preclude standards of care in developing countries, and there is much development needed in terms of meeting higher global standards for treating pediatric AKI patients. PD remains the main modality of choice for treatment of AKI in infants in developing world.

Issue Benefactors or Issue Victims? Ballot Initiative Influence on the Vote for California Governor, 1982-1998

THE CALIFORNIA Journal of Politics & Policy Volume 1, Issue 2 Issue Benefactors or Issue Victims? Ballot Initiative Influence on the Vote for California Governor, 1982–1998 Erik P. Bucy Indiana University, Bloomington Michael J. Ensley Indiana University, Bloomington Abstract Direct democracy, particularly the initiative process, has become an important fea- ture of the political landscape and influences the national agenda. California can- didates for governor regularly sponsor and endorse measures that appear on the ballot with their candidacies. This article combines endorsement evidence with exit polling data from five California gubernatorial elections (1982-98) to examine the effects of ballot propositions on gubernatorial elections. In the period examined, voting for winning initiatives was positively associated with voting for winning candidates. Conservative candidates who allied themselves with winning ballot ini- tiatives often benefited. Liberal candidates tended to support losing measures and liberal voters losing candidates. KEYWORDS: ballot initiative campaigns, issue voting, gubernatorial elections, California politics, direct democracy www.bepress.com/cjpp

Ideological Heterogeneity and the Rise of Donald Trump

Abstract In the days after the 2016 election, a variety of explanations has been offered to explain Donald Trump’s unique ascendancy in American politics. Scholars have discussed Trump’s appeal to rural voters, his hybrid media campaign strategy, shifts in voter turnout, Hillary Clinton’s campaign advertising strategy, economic anxiety, differences in sexist and racist attitudes among Trump voters and so forth. Here, we add another key factor to the conversation: Trump’s appeal to a smaller, often ignored, segment of the electorate: populist voters. Building upon our previous work – demonstrating that while American political elites compete across a single dimension of conflict, the American people organize their attitudes around two distinct dimensions, one economic and one social – we use 2008 American National Elections Study (ANES) data and 2016 ANES primary election data to show that populist support for Trump, and nationalist policies themselves, help us to understand how Trump captured the Republican nomination and the White House.