bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract 281: Antihypertensive Pharmacotherapy Eligibility Based Upon the 2017 ACC/AHA High Blood Pressure Clinical Practice Guidelines Among Young Adults Prior to Myocardial Infarction
Authors: Singh Avinainder , Collins Bradley , Gupta Ankur , DiCarli Marcelo F , Bhatt Deepak L , Nasir Khurram , Blankstein Ron
Published: April 2019

Introduction:
A recent study showed that in a cohort of young adults with MI (age ≤ 50 years) most young adults would not have been eligible for primary prevention statin therapy prior to their myocardial infarction (MI). Recent guidelines for hypertension re-define stage 1 hypertension to a systolic blood pressure (SBP) 130-139 mmHg or diastolic blood pressure (DBP) 80-89 mmHg and reclassify individuals with stage I hypertension and an elevated risk of atherosclerotic cardiovascular disease (ASCVD) to be eligible for pharmacotherapy. Our aim was to estimate the proportion of individuals with stage 1 hypertension who would be eligible for pharmacotherapy based on the 2017 hypertension guidelines among a cohort of adults ≤ 50 years of age prior to their MI.

Methods:
The YOUNG-MI registry is a retrospective cohort which includes patients who presented with a first MI at age ≤ 50 to two large academic centers. We simulated the eligibility for anti-hypertensive pharmacotherapy for each patient by assigning a SBP value ranging from 128mmHg to 140 mmHg in 2 mmHg increments, while assuming a normal DBP. All individuals diagnosed with diabetes or chronic kidney disease were considered to be eligible for anti-hypertensive pharmacotherapy if their SBP was greater than or equal to 130mmHg, per the guidelines. The pooled cohort equations were used to calculate the cardiovascular risk in the remaining patients. Those with an ASCVD of ≥ 10% and Stage 1 hypertension (SBP 130-139 mmHg) were considered to be eligible for pharmacotherapy.

Results:
Among 1838 adults, 284 (15.5%) had diabetes and 142 (9.2%) had chronic kidney disease and were thus classified as eligible for pharmacotherapy. The remaining 1412 individuals (median age 45 years, interquartile range 41-48 years; 17.1% women) had their eligibility determined based on the ASCVD risk score. In this group, the proportion eligible for anti-hypertensive therapy ranged from 7.7% (95% confidence interval 6.5%-9%) for a SBP of 130 to 11.4% (95% CI 9.8%-12.9%) for a SBP of 138
(Figure)
.

Conclusions:
While the new guidelines increase the number of individuals eligible for anti-hypertensive therapy, most young adults with Stage 1 hypertension would still not be eligible for pharmacotherapy prior to their MI, highlighting potential under-treatment of this at-risk young population.
Abstract 289: Factors Associated with Costs, Resource Utilization, and Mortality in Bentall Procedures
Authors: Walker Tara , Moore Matt
Published: April 2019

Purpose:
Studies investigating factors associated with procedure costs and resource utilization in Bentall procedures are rare, and the implications of operating room (OR) efficiencies on procedural outcomes for these complex and time consuming cardiac valve replacement procedures are unknown. The objective of this study was to use real world evidence to identify factors associated with inpatient mortality, overall length of stay (LOS), and total costs during an index hospitalization for a Bentall procedure.

Methods:
Eligible Bentall cases were identified in the Premier hospital database using a combination of ICD-9 and ICD-10 procedure codes for surgical aortic valve replacement (SAVR) and a text-mine of charge master billing files to identify the simultaneous use of an aortic conduit during the SAVR procedure. Multivariable regression models were estimated for LOS, mortality, and total index hospitalization costs. Each model was adjusted for patient demographics, comorbid conditions (as defined by Elixhauser Comorbidity Index), hospital characteristics, admission type (elective, urgent, or emergent), and operating room time (15 minute increments).

Results:
A total of 417 patients underwent a Bentall procedure between October 2014 and September 2017. Patients were primarily male (83%), Caucasian (80%), and married (63%), with a mean age of 57 years. Patients received more tissue valves (57%) and the majority of cases were elective procedures (61%) with a mean OR time of 440 minutes. Urgent and emergent procedures had longer mean operating room times, 60 minutes and 82 minutes respectively, and were significantly associated with increased hospital length of stay (2.16 days; p=0.0229, 3.03 days; p=0.0026). The analysis also found that a 15 minute increment of OR time was significantly associated with increased length of stay (1/4 day; p<0.0001), mortality (OR 1.07; p=0.021), and total hospitalization costs ($1,592; p<0.0001).

Conclusions:
Increased OR efficiencies are relevant to hospitals looking to improve outcomes, costs, and resource utilization associated with lengthy Bentall procedures, especially in urgent and emergent cases.
Abstract 293: Effect of Cardiovascular Health and Text Messaging (CHAT) on Risk Factor Management in Patients with Coronary Heart Disease: A Randomized Clinical Trial
Authors: Zheng Xin , Spatz Erica S , Bai Xueke , Huo Xiqian , Ding Qinglan , Horak Paul , Wu Xuekun , Guan Wenchi , Chow Clara K , Yan Xiaofang , Sun Ying , Wang Xiuling , Zhang Haibo , Liu Jiamin , Li Jing , Li Xi , Spertus John A , Masoudi Frederick A , Krumholz Harlan M
Published: April 2019

Background:
Mobile health technologies are low-cost, scalable interventions with the potential to promote patient engagement and behavior change. We designed and tested a tailored culturally-sensitive text messaging intervention to support secondary prevention in patients with coronary heart disease.

Methods:
In this multi-center, single-blinded randomized controlled trial, we enrolled 822 patients (mean age, 56.4 [SD, 9.5] years; 16.1% [132 of 822] women) with a history of AMI or PCI and without diabetes from 37 hospitals in China from August 2016 to March 2017. In addition to usual care, the control group (n=411) received 2 thank-you messages/month; the intervention group (n=411) received 6 text messages/week for 6 months delivered by an automated computerized system. The messages provided educational and motivational information related to disease-specific knowledge, risk factor control, physical activity and medication adherence. The primary endpoint was change in systolic blood pressure (SBP) from baseline to 6 months. Secondary end points included the proportion with SBP<140mmHg, smoking status, and change in BMI, LDL-C, and physical activity. The endpoints were assessed using analyses of covariance.

Results:
Follow up was 99.6% (819 of 822). The mean baseline SBP (SD) for the intervention and control groups were 130.9 (15.1) mmHg and 131.4 (17.5) mmHg, respectively. At 6 months, SBP was not significantly lower in the intervention group compared to the control group (mean SBP 127.8 vs. 129.4mmHg, p=0.089), with a mean change (SD) of 3.2 (14.3) mmHg and 2.0 (15.0) mmHg from baseline, respectively (mean net change -1.3mmHg [95%CI -3.3 to 0.8]; P=0.221). There were no significant differences in the change in LDL-C level, physical activity, BMI or smoking status between two groups. Nearly all patients in the intervention group reported the text messages to be useful (96.1%[389 of 405]), easy to understand (98.8%[400 of 405]), appropriate in frequency (93.8%[380 of 405]), and reported being willing to receive future text messages (94.8%[384 of 405]).

Conclusions:
Text messages supporting secondary prevention among patients with CHD did not lead to a greater reduction in blood pressure at 6 months. However, it was feasible and highly acceptable to patients.
Abstract 33: Impact of a Mobile Application for ACLS on House Staff Performance During Cardiac Arrest Simulations
Authors: Malik Ali O , Hejjaji Vittal , Peri-Okonny Poghni , Tang Yuanyuan , Thomas Merrill , Wooldridge David , Chan Paul S
Published: April 2019

Background:
Effective and timely delivery of cardiac arrest interventions during a resuscitation for in-hospital cardiac arrest (IHCA) is associated with a higher likelihood of survival. House staff play a pivotal role in leading resuscitations during IHCA. Whether a mobile application (App) that provides real-time reminders and dosing recommendations for defibrillation and vasoactive medications improves adherence to ACLS guidelines remains unknown.

Methods:
As part of a quality improvement initiative, internal medicine residents at Saint Luke’s Mid America Heart Institute underwent two different cardiac arrest simulations and were randomized to do one simulation with the App and one without. All simulations included 4 rhythm cycles and were video recorded to ensure accuracy in endpoint assessments. The co-primary endpoints were chest compression fraction (i.e., time doing chest compressions / total time of the simulation) and number of correct interventions (e.g., defibrillation, epinephrine or amiodarone within the correct time frame and with accurate dosing) out of 7 in each simulation. The secondary endpoint was incorrect interventions, defined as interventions not indicated by ACLS guidelines (e.g., atropine for asystole). Paired t-tests compared performance with and without the App.

Results:
Among 53 residents, 26 were randomized to do the first simulation with the App and 27 without the App. Use of the App was associated with a higher number of correct ACLS interventions (out of 7): mean of 6.2 vs. 5.1; absolute difference of 1.1 (95% CI: 0.6, 1.6); P<0.001) as well as fewer incorrect ACLS interventions (mean of 0.3 vs. 1.0; absolute difference of -0.7 (95% CI: -0.3, -1.0); P<0.001). Simulations performed with the App also had a marginally higher chest compression fraction (mean: 90.9% vs. 89.0%; absolute difference 2.0% (95% CI: 0.6%, 3.4%; P=0.007).

Conclusion:
Use of a mobile application by residents during simulations was associated with better adherence to ACLS performance measures. This proof-of-concept study suggests this novel mobile App may improve adherence to ACLS, but its effectiveness on survival in real-world resuscitations remains unknown.
Abstract 39: Creating a Dilated Cardiomyopathy Registry to Drive Population-level Quality Improvement Projects
Authors: Schwartz Bryanna , Badh Ranjodh , Jones Lisa , Jacobs Brian , Dham Niti
Published: April 2019

Background:
Since the passage of the Affordable Care Act, the health care system and medical professionals have been challenged to adopt population health strategies to deliver higher quality care to groups enrolled within a health system. Children’s National Health System (CNHS) has developed condition specific registries, which currently focus on seven condition specific population groups, one of which is dilated cardiomyopathy.

Objective:
To create, validate, and increase accuracy of data collected in a region-wide pediatric dilated cardiomyopathy registry to improve and deliver higher quality care and support data-driven population-level quality improvement projects across the pediatric health system.

Methods:
A multidisciplinary team was formed to develop measure specific inclusion and exclusion criteria based on specific ICD-10 and CPT codes. The clinical team reviewed and validated the criteria for seven clinical measures. The Business Intelligence team utilized HealtheIntent EDW (Enterprise Data Warehouse) and HealtheAnalytics to generate real-time reporting allowing clinical teams to monitor incoming patients. HealtheIntent enables real-time intelligence and data aggregation to occur directly from Cerner Millennium electronic health record. HealtheAnalytics technology then provides analytic tools to help with data visualization through time series charts and graphs reflecting improvement.

Results:
There are currently 113 patients with dilated cardiomyopathy tracked through the CNHS registry. For the initial measures tracked, 69% (n=78) had an outpatient cardiology visit and 32.3% (n=32) had a 24-hour Holter monitor performed in the last year as of Dec. 2018. Number of ED visits, hospitalizations, echocardiograms and flu shot compliance data is in the process of being collected. The registry was further developed to track patients by individual provider, so each cardiologist can see the specific metrics for each of their patients.

Discussion:
Health system registries, such as the CNHS registry, provide a unique opportunity to identify gaps in care and provide real-time, actionable data to providers with the goal of improving population health. Over the first year, there was a marked improvement in outpatient follow-up visits and 24-hour Holter monitors, however much of this can be attributed to data cleanup and mapping efforts to ensure patients met inclusion criteria and all tests were appropriately captured. It is essential for the registry to reflect accurate data in order to reduce unnecessary or duplicative visits or tests. The registry has allowed us to identify areas for quality improvement, including improved outpatient follow up and routine 24-hour Holter monitors. The next step is to engage pediatric cardiologists in using this real-time data to improve health outcomes and then using the registry to track results and initiate research studies.
Abstract 5: Cardiovascular Disease in Transgender Populations
Authors: Nguyen Tran , Alzahrani Talal , Dwairy Ahmad , Yunus Raza , McCaffery James , Ryan Angela , Forgione Joseph , Nagy Christian , Mazhari Ramesh , Reiner Johnathan
Published: April 2019

Background:
As of 2016, approximately 1.4 millions persons in the United States identify as transgender. Despite their growing number and increasing specific medical needs, there has been lack of research regarding cardiovascular disease (CVD) and CVD risk factors in this population. Recent studies have showed that transgender population had a significant higher rate CVD risk factors without a significant increase in overall CVD morbidity and mortality. These studies are limited by their small sample sizes and their predominant focus on younger transgender populations. With larger sample size and inclusion of broader age range, our study aims to provide more insights into the association between being transgender and cardiovascular risk factors, as well as, myocardial infarction (MI).

Methods:
The 2017 Behavioral Risk Factor Surveillance System (BRFSS) data was used to evaluate the correlation between being transgender and the rate of myocardial infarction (MI) and CVD risk factors. Logistic regression model was constructed to study the association between being transgender and rate of myocardial infarction after adjusting for CVD risk factors including age, diabetes, hypertension, hypercholesterolemia, chronic kidney disease, smoking, and exercise. Analyses were performed using SAS, version 9.4 and accounted for the complex survey design of BRFSS.

Results:
The weighted frequency of transgender men and transgender women in our cohort were 354,048 (0.46%) and 437,886 (0.61%), respectively. Multivariable analysis revealed that transgender men had more than seven-fold increase in the rate of MI (OR=7.39, 95% CI=2.95, 18.55, p<0.001) compared to cisgender women while transgender women did not have significant increase in the rate of MI (OR=1.54, 95% CI=0.95, 2.51, p=0.081) compared to cisgender men after adjusting for age, diabetes, hypertension, hypercholesterolemia, chronic kidney disease, smoking, and exercise.

Conclusion:
Transgender men are at higher rate of MI compared to cisgender women after adjusting for CVD risk factors.
Safety and Outcome of Intravenous Thrombolysis in Stroke Patients on Prophylactic Doses of Low Molecular Weight Heparins at Stroke Onset
Authors: Cooray Charith , Mazya Michael , Mikulik Robert , Jurak Lubomir , Brozman Miroslav , Ringleb Peter , Dixit Anand , Toni Danilo , Ahmed Niaz
Published: April 2019

Background and Purpose—

There are limited data on intravenous thrombolysis treatment in patients with ischemic stroke who have received prophylactic doses of low molecular weight heparins (LMWHs). We aimed to evaluate the safety and outcomes of intravenous thrombolysis treatment in stroke patients taking thromboprophylactic doses of LMWH.

Methods—

We analyzed 109 291patients treated with intravenous thrombolysis, recorded in the Safe Implementation of Treatments in Stroke International Thrombolysis Register between 2003 and 2017 not taking oral anticoagulants or therapeutic doses of heparin at stroke onset. One thousand four hundred eleven patients (1.3%) were on prophylactic LMWH for deep venous thrombosis prevention. Outcome measures were symptomatic intracerebral hemorrhage, parenchymal hematoma, death within 7 days and 3 months, and functional dependency at 3 months.

Results—

Patients on LMWH were older, had more severe strokes, more prestroke disability, and comorbidities than patients without LMWH. There was no significant increase in adjusted odds ratios (aOR) for symptomatic intracerebral hemorrhage (aOR, 1.02 [95% CI, 0.48–2.17] as per Safe Implementation of Treatments in Stroke -MOST, aOR, 0.95 [0.59–1.53] per ECASS II]), nor for 7-day mortality (aOR, 1.14 [0.82–1.59]), in the prophylactic LMWH group. The LMWH group had a higher aOR for 3-month mortality (aOR, 1.94 [1.49–2.53]) and functional dependency, aOR, 1.44 (1.10–1.90). Propensity score analysis matching patients on baseline characteristics removed differences between groups on all outcomes except 3-month mortality.

Conclusions—

Intravenous thrombolysis in patients with acute ischemic stroke on treatment with prophylactic doses of LMWH at stroke onset is not associated with an increased risk of symptomatic intracerebral hemorrhage or early death.
Remarks on the subfam. Betoideae (Chenopodiaceae/Amaranthaceae sensu APGIV)
Authors: IAMONICO DUILIO
Published: April 2019

Subfam. Betoideae (Amaranthaceae Juss./Chenopodiaceae Vent. sensu APGIV) is a monophyletic group which comprises five genera (Aphanisma, Beta, Hablitzia, Oreoblitum, and Patellifolia) and an undefined number of species (11‒16 according to the available literature). While the taxonomic position of the various groups in Betoideae is quite well studied and clarified, nomenclature is still poorly investigated and several names remain to be untypified. The present research has the aim to present a comprehensive view of all taxa (at all ranks) beloning to Betoideae by a list of their accepted names, main synonyms, and types. Taxonomic considerations were also made. The names Aphanisma blitoides, Beta patula, Beta lomatogona, Beta macrorhiza, Beta nana, Beta macrocarpa, Beta bourgaei (= Beta macrocarpa), Oreobliton thesioides, and Beta procumbens are typified on specimens deposited respectively at K (lecto-), BM (lecto-), LE (lecto-), H (lecto-), K (neo-, isoneotypes a FI, GOET, K, WAG), PAL (neo-), G (lecto-, isolectoypes a G, K), P, and C (neo-). The typification of the name Hablitzia tamnoides by Menitsky was discussed and accepted. A new nomenclature change [Beta sect. Corollinae subsect. Nanae (Ulbr.) Iamonico, comb. et stat. nov.] and two new taxa (Beta sect. Beta subsect. Patulae Iamonico, subsect. nov., and Beta sect. Macrocarpae Iamonico, sect. nov.) were proposed. A new classification of Subfam. Betoideae was proposed, including 2 tribes (Beteae, and Hablitzieae), 5 genera (Aphanisma, Beta, Hablitzia, Oreoblitum, and Patellifolia), and for the genus Beta 3 sections and 4 subsections (sect. Beta subsect. Beta, Beta sect. Beta subsect. Patulae Iamonico subsect. nov., sect. Corollinae subsect. Corollinae, sect. Corollinae subsect. nanae (Ulbr.) Iamonico comb. et stat. nov., Beta sect. Macrocarpae Iamonico sect. nov.).
A redescription of Moina australiensis Sars, 1896 (Cladocera: Moinidae) with short notes on Australian moinids
Authors: NERETINA ANNA N. , KIRDYASHEVA ANNA G.
Published: April 2019

Australia harbors numerous peculiar organisms, but microscopic aquatic invertebrates remain scarcely studied here. Cladocera (Crustacea: Branchiopoda) is considered as one of the most important models for freshwater biogeography, but the lack of adequate species identifications devalues large-scale biogeographical conclusions. In this paper we redescribe morphology of rare and poorly known Moina australiensis Sars, 1896 based on material from its terra typica. Among Australian moinids, M. australiensis is similar to M. tenuicornis Sars, 1896. These two taxa reliably differ from each other in (1) proportions of the antenna I and (2) armature of the inner margin of valve. M. australiensis has a relatively short antenna I and setulae near ventral setae on inner side of the valve grouped into bunches. M. tenuicornis has an elongated antenna I and setulae on described region forming a uniform, continuous row. Presumably, distribution ranges of both species are restricted to Australia. Also, according to literature data, M. baylyi Forró, 1985, M. flexuosa Sars, 1896 and M. propinqua Sars, 1885 may be considered as peculiar Australian taxa. At the same time, M. micrura Kurz, 1875, M. aff. weismanni Ishikawa, 1896 and Moinodaphnia macleayi (King, 1853) have significantly broader distribution ranges. In fact, distribution ranges of all these taxa should be re-evaluated in the future based on careful identification of species in the original samples. In this sense, newly conducted morphological redescriptions of some rare and poorly known taxa are only first steps to evaluation of moinid biodiversity in Australia and in the global scale.
Parasitoids of jumping plant-lice (Psylloidea, Hemiptera) from the family Encyrtidae (Hymenoptera, Chalcidoidea) in Serbia
Authors: JERINIĆ-PRODANOVIĆ DUŠANKA , MIHAJLOVIĆ LJUBODRAG , STOJANOVIĆ ALEKSANDAR
Published: April 2019

The aim of this research was to study the diversity of jumping plant-lice parasitoids and to investigate their potential in biological control applicable to cultivated and ornamental plants. Thirteen species from six genera of encyrtid wasps (Hymenoptera, Chalcidoidea, Encyrtidae) were reared from 24 species of jumping plant-lice (Hemiptera, Psylloidea) in Serbia. A total of 689 encyrtid wasps were collected since 2003 from 51 localities, reared from hosts. The richest genera are Psyllaephagus with four species (P. belanensis (Hoffer), P. fulvipes Erdös, P. procerus Mercet and Psyllaephagus sp.) and Syrphophagus with three species (S. aphidivorus (Mayr), S. taeniatus (Förster) and S. ariantes (Walker)). The most common species, comprising about half of the reared specimens, is Prionomitus mitratus (Dalman). Eight species are new to Serbia: Microterys annulatus (Erdös, 1957), Prionomitus tiliaris (Dalman), Psyllaephagus belanensis, P. fulvipes, P. procerus, Sectiliclava cleone (Walker), Syrphophagus ariantes and Trechnites flavipes (Mercet). Psyllaephagus fulvipes was reared from the nymphs of Craspedolepta conspersa (Löw), the only known host of this species so far. In the present study, 27 new host associations were found.
Numerical Simulations of Seasonal Variations of Rainfall over the Island of Hawaii
Authors: Huang Yu-Fen , Chen Yi-Leng
Published: April 2019

The seasonal variations of rainfall over the island of Hawaii are studied using the archives of the daily model run from the fifth-generation Pennsylvania State University–NCAR Mesoscale Model (MM5) from June 2004 to February 2010. Local effects mainly drive the rainfall on the Kona coast in the early morning and the lower slopes in the afternoon. During the summer, the incoming trade winds are more persistent and moister than in winter. The moisture content in the wake zone is higher than open-ocean values because of the convergent airflow associated with dual counterrotating vortices. As the westerly reversed flow moves toward the Kona coast, it decelerates with increasing moisture and a moisture maximum over the coastal area, especially in the afternoon hours in summer months. The higher afternoon rainfall on the Kona lower slopes in summer than in winter is caused by a moister (>6 mm) westerly reversed flow bringing moisture inland and merging with a stronger upslope flow resulting from solar heating. Higher nocturnal rainfall off the Kona coast in summer than in winter is caused by the low-level convergence between a moister westerly reversed flow and offshore flow. On the windward slopes, the simulated rainfall accumulation in winter is higher because of frequently occurring synoptic disturbances during the winter storm season. Nevertheless, early morning rainfall along the windward coast and afternoon rainfall over the windward slopes of the Kohala Mountains is lower in winter because the incoming trades are drier.
Interruptions and Delivery of Care in the Intensive Care Unit
Authors: Drews Frank A. , Markewitz Boaz A. , Stoddard Gregory J. , Samore Matthew H.
Published: April 2019

Objective:

This study samples interruption frequency in intensive care unit (ICU) settings to assess the relationship between interruptions and common patient hazards.

Background:

Task interruptions are accident contributors in numerous industries. Recently, studies on health care interruptions and their impact on patient hazards have received attention.

Method:

Seven ICUs in four hospitals participated in a 24-month study. Experienced ICU nurses directly observed nursing tasks, interruptions, and patient hazards (delays in care, breaks in device task protocols, and patient safety hazards).

Results:

During 1,148 hours of observation, 175 nurses performed 74,733 nursing tasks. Interruptions occurred at a rate of 4.95 per hour, and 8.4% of tasks were interrupted. Interruptions originated mostly from humans (65.9%), alarms (24.1%), and others (10%). A total of 774 patient hazards were observed, with a hazard occurring on average every 89 minutes. Relative to noninterrupted tasks, device alarm interrupted nonstructured tasks were associated with increased rates of delays in care and safety hazards (rate ratio [RR] = 3.19). In contrast, rate of delays in care and safety hazards did not increase during human interrupted tasks (RR = 1.13). Rates of protocol nonadherence varied by device type and were highest during artificial airway, medication administration, chest tube, and supplemental oxygen management.

Conclusion:

Interruptions in the ICU are frequent and contribute to patient hazards, especially when caused by device alarms during nonstructured tasks. Nonadherence to protocols is common and contributed to patient hazards.

Application:

The findings suggest a need for improvement in task and device design to reduce patient hazards.
EAT-PAD: Educating about psychiatric advance directives in India
Authors: Philip Sharad , Chandran Dhanya , Stezin Albert , Viswanathaiah Geetha C , Gowda Guru S , Moirangthem Sydney , Kumar Channaveerachari Naveen , Math Suresh Bada
Published: April 2019

Background:

With India enacting the Mental Health Care Act (MHCA; No. 10 of 2017a), Psychiatric Advance Directives (PADs) have been legalised and have become binding orders for psychiatrists treating patients. There is a paucity of research into acceptability of PADs in Indian mental health care, likely due to a lack of awareness. There are no educational measures about PADs provided for in this Act. Facilitators and facilitation methods have not been elaborated upon as well.

Aim:

The aim of this study is (a) to develop/evaluate the effectiveness of a structured Education-cum-Assessment Tool (EAT) in providing information regarding PADs and (b) to evaluate modes of facilitation required by patients to complete PADs.

Methods:

A tool was developed as per provisions regarding PADs in the Mental Health Care Bill of 2013. This tool was administered to patients ( n = 100), purposively sampled from the adult psychiatry review out-patient department (OPD). Patients were evaluated on retention of information, completion of PADs, modes of facilitation and time taken to write one.

Results:

Mean years of education was 8.28 (±5.74) years and mean duration of illness was 8.30 (±7.04) years. In all, 65% had Below-Poverty Line (BPL) status. All participants completed valid PADs in an average of 15 minutes. About 93% required facilitation via assistance in writing and reminding. The mean EAT scores implied above 70% retention but did not relate to types of facilitation.

Conclusions:

EAT scores can be used as an approximate measure of the patient’s ability to understand and retain information which is a part of decisional capacity. Types of facilitation can help in understanding patient’s ability to communicate their choices. Service providers may find EAT a time-effective tool for uniformly educating service users regarding PADs and indirectly assessing competence.
Understanding Hegemony of Caste in Political Islam and Sufism in Sindh, Pakistan
Authors: Hussain Ghulam
Published: April 2019

This paper is an attempt to investigate the historical trajectory of Ashrafia hegemony in Sindh, the province of Pakistan. I begin with the analysis of biopolitics of caste, class and religion organised around Hindu–Muslim binarism and unity as it unfolded during and after the partition of the Indian subcontinent. I particularly analyse the demographic shifts, the official categorisation of populations, and the communal and ethnonationalist claims that led to the specific kind of interpretation of religion, caste and class. Informed by the Ambedkarian subaltern perspective and based on the analysis of ethnographic data and vernacular literature, I explain that nationalist ideologies framed in the narratives of political Islam and Sufism tend to organise politics around Hindu–Muslim otherness, as in case of Pakistani nationalism, and Hindu–Muslim harmony, as in case of Sindhi nationalism. Based on that understanding, I argue that Ashrafia advantage, by and large, is the product of pre-existing historical hegemonic relations than any conscious strategy, and or directly imposed domination. Since both the Ashrafia narratives primarily imagine people through religious binaries, they lack the counter-hegemonic elements that could confront casteism that lies at the intersection of class and religion. None of the narratives, being performative projections of the ideal religious society, brought casteism in their focus while dealing with the structural inequalities, social hierarchies and the issues of political representation of the Dalit class. It resulted in the unwarranted legitimacy for Ashrafia hegemony, Jati Hindu domination and Dalit subordination. This re-hierarchised caste groups and continue to (re)distribute the caste capital by (re)producing Sayedism, Dalit exclusion and caste-class oligarchies.
Selecting Immigrants in an Unjust World
Authors: Ip Kevin KW
Published: April 2019

For many individuals living in poor societies, migration is the best hope for improving their life prospect. However, global migration today is highly selective and stratified. Affluent states often enjoy great discretion to cherry pick their immigration, favouring those with particular skills and qualifications. In this article, I argue that this practice of selective immigration is morally permissible only when a set of demanding conditions are met. I also argue that their right to exclude potential immigrants is constrained by the background distributive injustice in the global context.
Compensating for the Climate: Unemployment Insurance and Climate Change Votes
Authors: Kono Daniel Yuichi
Published: April 2019

Global climate change is a pressing political issue, yet some governments have done more to address it than others. Building on the “compensation hypothesis” from the international trade literature, I argue that legislators are more willing to support carbon restrictions when workers in their districts are protected by generous unemployment insurance. I test this hypothesis with an analysis of Congressional climate change votes. I find that higher carbon-intensive employment makes legislators less likely to vote for carbon restrictions, but this effect is weaker where unemployment benefits are high. I also find that generous unemployment benefits make legislators more likely to vote for carbon restrictions but only where carbon-intensive employment is high. My results imply that generous unemployment insurance can help governments to pass stronger climate change legislation. More broadly, they indicate that struggles over the welfare state have important consequences for other policy domains.
Reform and resistance: The political economy of land and planning reform in Kenya
Authors: Bassett Ellen
Published: April 2019

In August 2010, Kenyans voted to adopt a new Constitution. Amongst its many provisions was devolved governance, which established 47 independent counties each led by a directly elected governor and legislative assembly. The Constitution also sought to address the country’s ‘land question’ by radically reworking land institutions and administration. The Constitution introduced an independent body, the National Land Commission, empowered to oversee public land management and allocation. Constitutional provisions devolved significant powers and responsibilities in land management and planning to the county level. These reforms – stressing transparency, accountability and greater community participation in land planning and administration – were intended to halt endemic corruption at the Ministry of Lands, address land injustices, enhance tenure security, and facilitate better-functioning land markets. This paper examines the unfolding institutional reform around land pursuant to the 2010 Constitution. It explores the political economy of land in Kenya by examining incentives for and impediments to institutional change toward better land management and long sought-after land justice. As with many reforms adopted throughout the Global South, Kenya’s land reforms were premised on ‘getting the incentives right’. Incentivising behaviour is extremely complicated in a sector as complex, dynamic and profitable as the land sector. The research highlights the role of urban planners, actors rarely examined in the literature on Kenya’s land politics. Kenya’s faltering land reform is a result of the internal conflicting incentives of land actors and the fact that no legal reform will be sufficient to alter entrenched behaviour without renewed pressure from a broad-based land justice/human rights movement.
Gentrifiers, distinction, and social preservation: A case study in consumption on Mount Pleasant Street in Washington, DC
Authors: Riely Andrew
Published: April 2019

Mount Pleasant, a neighbourhood of Washington, DC that has experienced several decades of residential gentrification (Gale, 1980; Modan, 2007; Williams, 1988), nonetheless possesses a commercial corridor where local stores far outnumber boutique retail and corporate chain outlets. Its situation challenges a critical strain within the commercial gentrification literature that emphasises the likelihood of retail displacement during the gentrification process and characterises gentrifier consumers as primarily interested in retail outlets that are familiar or carefully designed to suit their taste. This study investigates gentrifiers’ consumption practices in Mount Pleasant to ascertain how they differ from those of peers in neighbourhoods where gentrification has followed a more typical trajectory. Using theories of distinction (Bourdieu, 1984) and social preservation (Brown-Saracino, 2009), I argue that many local gentrifiers, contradictorily, seek to accrue cultural capital by consuming ‘authentic’ local culture and products while paying attention to the costs of turnover and displacement.
Urban Agriculture in shared spaces: The difficulties with collaboration in an age of austerity
Authors: St Clair Rebecca , Hardman Michael , Armitage Richard P , Sherriff Graeme
Published: April 2019

The expanding critical literature on Urban Agriculture (UA) makes links between the withdrawal of state services and the institutionalisation of volunteering, while observing that challenging funding landscapes can foster competitive environments between third-sector organisations. Where these organisations are forced to compete for survival at the expense of collaboration, their ability to collectively upscale and expand beneficial activities can be compromised. This paper focuses on a lottery-funded UA project and draws predominantly on observations and interviews held with project staff and growing group volunteers. Research conducted in Wythenshawe, Manchester (UK), highlights difficulties experienced by organisations attempting to function in an environment disfigured by depletion, illustrating conflicts that can arise between community groups and charitable organisations competing for space and resources. Inter-organisational dynamics are considered at two scales: at the grassroots level between growing groups, and at a structural level between project partners. In a landscape scarred by local authority cutbacks and restructures, a dearth of funding opportunities and increasingly precarious employment, external initiatives can be met with suspicion or hostility, particularly when viewed as superfluous interventions. The resulting ‘siege mentality’ reflects the need for organisational self-preservation but perhaps paradoxically results in groups with similar goals and complementary ideologies working against each other rather than in cooperation.
Having Less But Giving More: Work Experience and Prosocial Behavior of Chinese Working-Class Youth
Authors: Hui Bryant P. H. , Ngai Pun , Qiu Jack Linchuan , Koo Anita
Published: April 2019

Adolescent behavior is often negatively viewed especially regarding work experience. By introducing a concept of prosocial behavior, our study attempts to provide an alternative view on the effects of teenage job and work experience. We hypothesized that work experience could generate more prosocial behaviors. By surveying a large group of working-class youth ( N = 2,860) from eight Chinese vocational schools and using structural equation modeling, we confirmed that the pattern of “having less, giving more” could be found in our sample. Our findings revealed that work experience could facilitate prosocial behavior via the increase of knowledge of both contract-based rights and labor action. By understanding working-class youth’s prosocial behavior as a positive outcome of work experience, this study calls for further research on other positive outcomes, such as cooperation, civic engagement, and solidarity, among working-class youth.
Revisiting ABO incompatibility as a risk factor for significant neonatal hyperbilirubinemia
Authors: Khurana Ritika , Batra Prerna , Faridi MMA , Khan Nirupama
Published: April 2019

Babies with ABO incompatibility are often advised frequent biochemical screening and prolonged hospital stay. Our primary objective of the study was to compare serum bilirubin levels at 48 h and 96 h of age in neonates with and without ABO incompatibility. Our prospective study included neonates with gestation ≥ 34 weeks, with or without ABO incompatibility (92 in each group). A direct Coombs test was performed on cord blood. The mean serum bilirubin and haematocrit levels in both groups at 48 h and 96 h were comparable. The mean reticulocyte count of babies with ABO incompatibility was, however, significantly higher. Late preterm and term neonates with and without ABO incompatibility have similar bilirubin levels and no increased risk of significant hyperbilirubinemia. Prolonged hospitalisation of these neonates appears to be unnecessary.
Developments in Australian, British, and American English Grammar from 1931 to 2006: An Aggregate, Comparative Approach to Dialectal Variation and Change
Authors: Yao Xinyue , Collins Peter
Published: April 2019

This study investigates overall grammatical developments of written Australian English (AusE) across the twentieth century. Adopting an aggregate approach to language variation and change, it examines the distribution of a range of grammatical features which have previously been shown to be sensitive to variation over time. Multi-generic data were drawn from “AusBrown,” a set of balanced diachronic corpora following the design of the Brown family of corpora. Multivariate techniques such as hierarchical cluster analysis and multidimensional scaling were employed to outline the developmental path of AusE in relation to those of British and American English in order to shed light on the possible emergence of regional patterns. The results suggest that the period from the 1960s to the 1990s was one critical for the evolution of written AusE, preceded by a period of relative stagnation and followed by one characterized by a coalescence of the three varieties. Such a developmental path is largely compatible with significant sociohistorical trends that have shaped the language attitudes of Australians, including strong connections with its British legacy in the first few decades, political independence and rapid social progress in the mid-twentieth century, and accelerated globalization as a result of major technological advances towards the end of the century. Additionally, the findings reveal the dominance of features contributing to colloquialization and densification in the texts examined.
Test of the Social Buffering Hypothesis in the Context of Religious Disagreements
Authors: McLaughlin Aaron T. , Shodiya-Zeumault Shola , McElroy-Heltzel Stacey , Davis Don E. , McLaughlin-Sheasby Amy , Hook Joshua N.
Published: April 2019

This article examines the social buffering hypothesis of cultural humility in the context of religious offenses. In this study, participants ( N = 244) rated their cultural humility in terms of differing religious values and beliefs as well as their moral foundations in determining what is right or wrong. They then recalled an offense or hurt attributed to religious disagreements and indicated their motivations for forgiving the offender. Lower endorsement of individuating moral foundations predicted greater unforgiveness; however, cultural humility softened this relationship between individuating moral foundations and unforgiveness. When cultural humility was higher, participants were less likely to report unforgiveness motivations toward the religious offender, even if their individuating moral foundation scores were lower. Results from this study support the social buffering hypothesis of humility. Namely, individuals with higher levels of cultural humility demonstrate a greater capacity to maintain relationships during stressful religious disagreements by regulating intuitive and affective moral positions, particularly those that have previously been linked to social dominance or moral disinterest. We conclude this study by discussing limitations, practical applications, and areas for future research.
Cultural Humility: Introduction to the Special Issue
Authors: Hook Joshua N. , Davis Don E.
Published: April 2019

This issue of the Journal of Psychology and Theology focuses on cultural humility. Cultural humility is an important domain of general humility that focuses on cultural differences. In this introduction to the special issue, we first define cultural humility, and briefly share some history for how the construct has developed over time. Then, we present some theory and research that has explored cultural humility in the context of religious, spiritual, and ideological differences and conflict. After sharing some background theory and research on cultural humility, we summarize the subsequent articles in this special issue.
Consumption Plus Love: Inequality, Domestic Utopia, and China’s New Politics of the Future
Authors: Sun Wanning
Published: April 2019

With hundreds of millions of rural migrant workers now dominating the labor market in China’s fastest growing regions, this group embodies that nation’s most intractable problems of inequality. Young, single, socially disenfranchised rural migrants, particularly men, reportedly experience widespread difficulty in finding a marriage partner, largely because they cannot afford to buy a home. The resulting potential social instability is of pressing concern to the Chinese Communist Party. How do discourses of governmentality reconcile/manage class inequality? How do they construct the future and encourage hope? What moral, cultural, and rhetorical resources does this ideology of the future draw on, and to what extent does it represent a rupture with China’s revolutionary—and traditional—past? Do China’s most disenfranchised socioeconomic groups buy into the “China Dream” rhetoric? This article addresses these questions through a series of “love stories” screened by China Central Television. It pinpoints a particular moment in China’s state capitalism when romantic love became a means of managing, if not solving, social inequality. It uncovers a new discursive blueprint for future state narratives of inequality and brings to light some new ways of restructuring the fantasy of the “good life.”
Basin evolution, configuration styles, and hydrocarbon accumulation of the South Atlantic conjugate margins
Authors: Wen Zhixin , Jiang Shu , Song Chengpeng , Wang Zhaoming , He Zhengjun
Published: April 2019

The basins of the South Atlantic passive margins are filled with early rifting stage lacustrine sediments (Barremian, 129–125 Ma), transitional lacustrine and marine sediments (Aptian, 125–113 Ma), and drift stage marine sediments since early Cretaceous (Albian, 113 Ma). The South Atlantic margins can be divided into three segments by the Rio Grande Fracture Zone and the Ascension Fracture Zone according to variations in the basin evolution history and configuration style. The lacustrine shale and marine shale source rocks are developed in the rift stage and drift (post-rift) stage in the South Atlantic passive margins, respectively. The southern segment of the margins is dominated by the lacustrine sedimentary filling in the rifted stage overlain by a thin marine sag system as a regional seal, where the hydrocarbons are mainly accumulated in the structural-stratigraphic lacustrine reservoirs formed in the rift stage. The middle segment developed salty rift-sag-type basins with rift and sag systems and with salt deposited in the transitional intercontinental rift stage, where the lacustrine shale in the lower part of the rifted lacustrine sequence and the marine shale in the lower part of the sag sequence formed in the marine post-rift stage are high-quality source rocks. This segment in the middle is mainly dominated by pre-salt lacustrine carbonate and post-salt marine turbidite plays. The northern segment is characterized by sag-type basins with a narrowly and locally distributed rifted lacustrine system and its overlying widely distributed thick marine sag systems. Gravity-flow (mostly turbidite) marine sandstones as good reservoirs were extensively developed in the sag stage due to the narrow shelf and steep slope. The post-rift marine shales in the lower part of the sag sequence are the main source rocks in the northern segment and the hydrocarbons generated from these source rocks directly migrated to and accumulated in the deep marine turbidite sandstones in the same sag sequence formed in the drift stage. From southern segment to northern segment, source rocks and hydrocarbon accumulations tend to occur in the stratigraphically higher formations. The hydrocarbon accumulations in the southern segment are mainly distributed in the rifted lacustrine sequence while that in the northern segment primarily occur in the post-rift marine sequence.
Intralingual Mucous Extravasation Cyst: An Uncommon Lingual Cyst
Authors: Diom Evelyne S. , Fagan Johannes J. , Bolding Ellen
Published: April 2019

Objective:

We report a rare case of an intralingual ranula. The differential diagnosis, etiology, diagnostic features, and management are discussed.

Case Report:

An 18-year-old man presented with a mass that extended along the ventral surface of the tongue and up to the tip. The computed tomography scan clearly defined the extent of a cystic lesion. The pathologic diagnosis of an intralingual ranula was made.

Conclusion:

Lingual cysts have a varied etiology. Diagnosis hinges on histological examination of the cyst wall. Conservative resection and histological examination is the standard of care.