Band of Brothers or Band of Others?: Rhetoric, Veterans, and Civil Rights Fights in Germany and the United States
Abstract: Research suggests that marginalized groups can use military service to win greater governmental and social acceptance by using civic republican rhetoric, however, conditions in which claims-making rhetoric is coercive are underspecified. Because rhetorical effectiveness requires sympathetic ears, we examine the influence of (1) expectations and political efforts of marginalized group members seeking greater acceptance, (2) whether majority group economic status is outpacing marginalized groups seeking improved treatment, and (3) whether marginalized groups have influential military veterans from majority groups as allies. We apply these factors to explain the claims-making failure of German Jews following the First World War and the success of African Americans after the Second World War. From the African American case, we also conclude that military service led to greater socio-political inclusion and rights based on development of future political actors through leadership development processes and inter-group contact, especially regarding Presidents Truman and Eisenhower.
Abstract: Novel and automated means of opioid use and relapse risk detection are needed. Unstructured electronic medical record data, including written progress notes, can be mined for clinically relevant information, including the presence of substance use and relapse-critical markers of risk and recovery from opioid use disorder (OUD). In this study, we used natural language processing (NLP) to automate the extraction of opioid relapses, and the timing of these occurrences, from veteran patients' electronic medical record. We then demonstrated the utility of our NLP tool via analysis of pre-/post-COVID-19 opioid relapse trends among veterans with OUD. For this demonstration, we analyzed data from 107,606 veterans OUD enrolled in Veterans Health Administration, comparing a pandemic-exposed cohort (n = 53,803; January 2019-March 2021) to a matched prepandemic cohort (n = 53,803; October 2017-December 2019). The recall of our NLP tool was 75% and our precision was 94%, demonstrating moderate sensitivity and excellent specificity. Using the NLP tool, we found that the odds of opioid relapse postpandemic onset were proportionally higher compared to prepandemic trends, despite patients having fewer mental health encounters from which to derive instances of relapse postpandemic onset. In this research application of the tool, and as hypothesized, we found that opioid relapse risk was elevated postpandemic. The application of NLP Methods: to identify and monitor relapse risk holds promise for future surveillance, risk prevention, and clinical outcome research.