bluuebunny/crossref_metadata_2025 huggingface dataset:
Ten-Year Clinical Outcome After Circumferential Pulmonary Vein Isolation Utilizing the Hamburg Approach in Patients With Symptomatic Drug-Refractory Paroxysmal Atrial Fibrillation
Authors: Tilz Roland Richard , Heeger Christian-Hendrik , Wick Alexander , Saguner Ardan M. , Metzner Andreas , Rillig Andreas , Wohlmuth Peter , Reissmann Bruno , Lemeš Christine , Maurer Tilman , Santoro Francesco , Riedl Johannes , Sohns Christian , Mathew Shibu , Kuck Karl-Heinz , Ouyang Feifan
Published: February 2018

Background:

Circumferential pulmonary vein isolation (CPVI) is increasingly performed for the treatment of symptomatic drug-refractory paroxysmal atrial fibrillation. Long-term data for >10 years after CPVI are sparse. We investigated the long-term clinical outcome and progression of paroxysmal atrial fibrillation after double-lasso and 3-dimensional electroanatomical mapping–guided CPVI.

Methods and Results:

From 2003 to 2004, 161 patients (mean age: 60±10 years) with symptomatic drug-refractory paroxysmal atrial fibrillation were prospectively enrolled and underwent electroanatomical mapping–guided CPVI. Right-sided and left-sided continuous circular lesions encircling the ipsilateral pulmonary veins were placed with irrigated radiofrequency energy. The procedural end point was the absence of pulmonary vein spikes 30 minutes after CPVI verified by 2 spiral catheters placed within the ipsilateral pulmonary veins (double-lasso technique). Major periprocedural complications occurred in 5 of 161 patients (3.1%). Follow-up was based on outpatient clinic visits, including Holter-ECGs and telephonic interviews. After a single procedure and median follow-up of 129.0 months (interquartile range, 124.7–133.1 months), stable sinus rhythm was present in 53 of 161 (32.9%) patients. Multiprocedural outcome after a mean of 1.73±0.9 procedures and a median follow-up of 123.4 months (interquartile range, 61.0–131.0 months) resulted in stable sinus rhythm in 101 of 161 patients (62.7%). Progression toward persistent atrial fibrillation was observed in 10 of 161 patients (6.2%).

Conclusion:

Ten-year single-procedural outcome of CPVI in patients with paroxysmal atrial fibrillation resulted in stable sinus rhythm in 32.9% and in 62.7% of patients after multiple procedures. The progression rate to persistent AF was remarkably low.
Use of Serum Transthyretin as a Prognostic Indicator and Predictor of Outcome in Cardiac Amyloid Disease Associated With Wild-Type Transthyretin
Authors: Hanson Jacquelyn L.S. , Arvanitis Marios , Koch Clarissa M. , Berk John L. , Ruberg Frederick L. , Prokaeva Tatiana , Connors Lawreen H.
Published: February 2018

Background:

Wild-type transthyretin amyloidosis (ATTRwt), an underappreciated cause of heart failure in older adults, is challenging to diagnose and monitor in the absence of validated, disease-specific biomarkers. We examined the prognostic use and survival association of serum TTR (transthyretin) concentration in ATTRwt.

Methods and Results:

Patients with biopsy-proven ATTRwt were retrospectively identified. Serum TTR, cardiac biomarkers, and echocardiographic parameters were assessed at baseline and follow-up evaluations. Statistical analyses included Kaplan–Meier method, Cox proportional hazard survival models, and receiver-operating characteristic curve analysis. Median serum TTR concentration at presentation was 23 mg/dL (n=116). Multivariate predictors of shorter overall survival were decreased TTR, left ventricular ejection fraction and elevated cTn-I (cardiac troponin I); an inclusive model demonstrated superior accuracy in 4-year survival prediction by receiver-operating characteristic curve analysis (area under the curve, 0.77). TTR values lower than the normal limit, <18 mg/dL, were associated with shorter survival (2.8 versus 4.1 years;
P
=0.03). Further, TTR values at 1- and 2-year follow-ups were significantly lower (
P
<0.001) in untreated patients (n=23) compared with those treated with TTR stabilizer, diflunisal (n=12), after baseline evaluation. During 2-year follow-up, unchanged TTR corresponded to increased cTn-I (
P
=0.006) in untreated patients; conversely, the diflunisal-treated group showed increased TTR (
P
=0.001) and stabilized cTn-I and left ventricular ejection fraction at 1 year.

Conclusions:

In this series of biopsy-proven ATTRwt, lower baseline serum TTR concentration was associated with shorter survival as an independent predictor of outcome. Longitudinal analysis demonstrated that decreasing TTR corresponded to worsening cardiac function. These data suggest that TTR may be a useful prognostic marker and predictor of outcome in ATTRwt.
Molecular Imaging in Drug Discovery and Development
Authors: Lindner Jonathan R. , Link Jeanne
Published: February 2018

Noninvasive imaging has played an increasing role in the process of cardiovascular drug development. This review focuses specifically on the use of molecular imaging, which has been increasingly applied to improve and accelerate certain preclinical steps in drug development, including the identification of appropriate therapeutic targets, evaluation of on-target and off-target effects of candidate therapies, assessment of dose response, and the evaluation of drug or biological biodistribution and pharmacodynamics. Unlike the case in cancer medicine, in cardiovascular medicine, molecular imaging has not been used as a primary surrogate clinical end point for drug approval. However, molecular imaging has been applied in early clinical trials, particularly in phase 0 studies, to demonstrate proof-of-concept or to explain variation in treatment effect. Many of these applications where molecular imaging has been used in drug development have involved the retasking of technologies that were originally intended as clinical diagnostics. With greater experience and recognition of the rich information provided by in vivo molecular imaging, it is anticipated that it will increasingly be used to address the enormous time and costs associated with bringing a new drug to clinical launch.
Quantitative Flow Ratio Identifies Nonculprit Coronary Lesions Requiring Revascularization in Patients With ST-Segment–Elevation Myocardial Infarction and Multivessel Disease
Authors: Spitaleri Giosafat , Tebaldi Matteo , Biscaglia Simone , Westra Jelmer , Brugaletta Salvatore , Erriquez Andrea , Passarini Giulia , Brieda Alessandro , Leone Antonio Maria , Picchi Andrea , Ielasi Alfonso , Girolamo Domenico Di , Trani Carlo , Ferrari Roberto , Reiber Johan H.C. , Valgimigli Marco , Sabatè Manel , Campo Gianluca
Published: February 2018

Background—

The nonculprit lesion (NCL) management in ST-segment–elevation myocardial infarction patients with multivessel disease is debated. We sought to assess whether quantitative flow ratio (QFR), a noninvasive tool to identify potentially flow-limiting lesions, may be reliable in this scenario.

Methods and Results—

The present proof-of-concept study is based on a 3-step process: (1) identification of the QFR reproducibility in NCLs assessment (cohort A, n=31); (2) prospective validation of QFR diagnostic accuracy in respect to fractional flow reserve (cohort B, n=45); and (3) investigation of long-term clinical outcomes of NCLs stratified according to QFR (cohort C, n=110). A blinded core laboratory computed QFR values for all NCLs. Cohort A showed a good correlation and agreement between QFR values at index (acute) and at staged (subacute, 3–4 days later) procedures (
r
=0.98; 95% confidence interval, 0.96–0.99; mean difference, 0.004 [−0.027 to 0.34]). The inter-rater agreement was κ=0.9. In cohort B, fractional flow reserve and QFR identified 16 (33%) and 17 (35%) NCLs potentially flow limiting. Sensitivity, specificity, negative, and positive predictive values were 88%, 97%, 94%, and 94%. The area under the receiver operating characteristics curve was 0.96 (95% confidence interval, 0.89–0.99). Finally, in cohort C, we identified 110 ST-segment–elevation myocardial infarction patients where at least 1 NCL was left untreated. Patients with NCLs showing a QFR value ≤0.80 were at higher risk of adverse events (hazard ratio, 2.3; 95% confidence interval, 1.2–4.5;
P
=0.01).

Conclusions—

In a limited and selected study population, our study showed that QFR computation may be a safe and reliable tool to guide coronary revascularization of NCLs in ST-segment–elevation myocardial infarction patients.
Sex Differences in Ischemic Heart Disease
Authors: Aggarwal Niti R. , Patel Hena N. , Mehta Laxmi S. , Sanghani Rupa M. , Lundberg Gina P. , Lewis Sandra J. , Mendelson Marla A. , Wood Malissa J. , Volgman Annabelle S. , Mieres Jennifer H.
Published: February 2018

Evolving knowledge of sex-specific presentations, improved recognition of conventional and novel risk factors, and expanded understanding of the sex-specific pathophysiology of ischemic heart disease have resulted in improved clinical outcomes in women. Yet, ischemic heart disease continues to be the leading cause of morbidity and mortality in women in the United States. The important publication by the Institute of Medicine titled “Women’s Health Research—Progress, Pitfalls, and Promise,” highlights the persistent disparities in cardiovascular disease burden among subgroups of women, particularly women who are socially disadvantaged because of race, ethnicity, income level, and educational attainment. These important health disparities reflect underrepresentation of women in research, with the resultant unfavorable impact on diagnosis, prevention, and treatment strategies in women at risk for cardiovascular disease. Causes of disparities are multifactorial and related to differences in risk factor prevalence, access to care, use of evidence-based guidelines, and social and environmental factors. Lack of awareness in both the public and medical community, as well as existing knowledge gap regarding sex-specific differences in presentation, risk factors, pathophysiology, and response to treatment for ischemic heart disease, further contribute to outcome disparities. There is a critical need for implementation of sex- and gender-specific strategies to improve cardiovascular outcomes. This review is tailored to meet the needs of a busy clinician and summarizes the contemporary trends, characterizes current sex-specific outcome disparities, delineates challenges, and proposes transformative solutions for improvement of the full spectrum of ischemic heart disease clinical care and research in women.
Novel Patient‐Centered Approach to Facilitate Same‐Day Discharge in Patients Undergoing Elective Percutaneous Coronary Intervention
Authors: Amin Amit P. , Crimmins‐Reda Patricia , Miller Samantha , Rahn Brandon , Caruso Mary , Pierce Andrew , Dennis Brandy , Pendegraft Marissa , Sorensen Katrine , Kurz Howard I. , Lasala John M. , Zajarias Alan , Bach Richard G. , Kulkarni Hemant , Singh Jasvindar
Published: February 2018

Background

Same‐day discharge (
SDD
) after elective percutaneous coronary intervention is safe, less costly, and preferred by patients, but it is usually performed in low‐risk patients, if at all. To increase the appropriate use of
SDD
in more complex patients, we implemented a “patient‐centered” protocol based on risk of complications at Barnes‐Jewish Hospital.

Methods and Results

Our objectives were as follows: (1) to evaluate time trends in
SDD
; (2) to compare (a) mortality, bleeding, and acute kidney injury, (b) patient satisfaction, and (c) hospital costs by
SDD
versus no SDD (
NSDD
); and (3) to compare
SDD
eligibility by our patient‐centered approach versus Society for Cardiovascular Angiography and Interventions guidelines. Our patient‐centered approach was based on prospectively identifying personalized bleeding, mortality, and acute kidney injury risks, with a personalized safe contrast limit and mitigating those risks. We analyzed Barnes‐Jewish Hospital's National Cardiovascular Data Registry Cath
PCI
Registry data from July 1, 2009 to September 30, 2015 (N=1752).
SDD
increased rapidly from 0% to 77% (
P
<0.001), independent of radial access. Although
SDD
patients were comparable to
NSDD
patients,
SDD
was not associated with adverse outcomes (0% mortality, 0% bleeds, and 0.4% acute kidney injury). Patient satisfaction was high with
SDD
. Propensity score–adjusted costs were $7331 lower/
SDD
patient (
P
<0.001), saving an estimated $1.8 million annually. Only 16 patients (6.95%) met the eligibility for
SDD
by Society for Cardiovascular Angiography and Interventions guidelines, implying our patient‐centered approach markedly increased
SDD
eligibility.

Conclusions

With a patient‐centered approach,
SDD
rapidly increased and was safe in 75% of patients undergoing elective percutaneous coronary intervention, despite patient complexity. Patient satisfaction was high, and hospital costs were lower. Patient‐centered decision making to facilitate
SDD
is an important opportunity to improve the value of percutaneous coronary intervention.
Differential Clinical Outcomes Between Angiographic Complete Versus Incomplete Coronary Revascularization, According to the Presence of Chronic Kidney Disease in the Drug‐Eluting Stent Era
Authors: Kim Jihoon , Lee Joo Myung , Choi Ki Hong , Rhee Tae‐Min , Hwang Doyeon , Park Jonghanne , Ahn Chul , Park Taek Kyu , Yang Jeong Hoon , Song Young Bin , Choi Jin‐Ho , Hahn Joo‐Yong , Choi Seung‐Hyuk , Gwon Hyeon‐Cheol
Published: February 2018

Background

There are limited data regarding the prognostic impact of angiographic complete revascularization (
CR
) in patients with chronic kidney disease (
CKD
). We sought to investigate the differential prognostic impact of angiographic
CR
over incomplete revascularization (
IR
), according to the presence of
CKD
in the drug‐eluting stent era.

Methods and Results

Between 2003 and 2011 at Samsung Medical Center, consecutive patients with multivessel disease were stratified by the presence of
CKD
(estimated glomerular filtration rate <60 mL/min per 1.73 m
2
) and classified according to angiographic
CR
(residual
SYNTAX
score=0) or
IR
. Clinical outcomes were compared between angiographic
CR
and
IR
, stratified by the presence of
CKD
. Primary outcome was patient‐oriented composite outcomes (
POCO
, a composite of all‐cause death, myocardial infarction, any revascularization) at 3 years. Inverse probability weighting was performed between the
CR
and
IR
groups. A total of 3224 patients were eligible for analysis: 2295 without
CKD
; 929 with
CKD
. Among non‐
CKD
patients, angiographic
CR
showed a significantly lower risk of
POCO
than
IR
(17.2% versus 21.7%, adjusted hazard ratio 0.76, 95% confidence interval, 0.62–0.95,
P
=0.014), mainly driven by a significantly lower risk of any revascularization. Among
CKD
patients, however, angiographic
CR
was associated with a significantly higher risk of
POCO
than
IR
(37.7% versus 28.4%, adjusted hazard ratio 1.42, 95% confidence interval, 1.08%–1.85%,
P
=0.011), mainly driven by a significantly higher risk of nonfatal target vessel myocardial infarction.

Conclusions

Angiographic
CR
was associated with reduced risk of
POCO
than
IR
in patients without
CKD
; however, it was associated with a significantly higher risk of
POCO
and nonfatal myocardial infarction in
CKD
patients.
A Legal Obligation to Restore Wetlands by Environmental Water Allocations
Authors: Jensen Jeanette , Gardner Alex
Published: February 2018

Wetlands worldwide require significant restoration, especially through environmental water allocations. This article examines the Ramsar Convention (Ramsar) and the Convention on Biological Diversity (cbd) to ascertain whether they require an obligation to restore wetlands by such means. While both conventions contain a general obligation to restore, that obligation appears too uncertain, due to either the disputable status of the language of the text (Ramsar) or the qualifying language expressing it (cbd). The Ramsar obligation, arguably, amounts to a legal obligation that is potentially enforceable in the icj against another contracting party. The article recognizes that the obligation is practically difficult to enforce because: the Convention does not provide a formal dispute settlement procedure; the obligation is derived from guidance in numerous Conference of the Parties resolutions, and is subject to certain exceptions. Further, there is a judicial reluctance to find that the facts prove a breach of the obligations and warrant a remedy. The authors argue, however, that restoration goals are, in fact, achievable through Convention amendments or by an additional protocol.
Iris tibetica, a new combination in I. ser. Lacteae (Iridaceae) from China: evidence from morphological and chloroplast DNA analyses
Authors: BOLTENKOV EUGENY V. , ARTYUKOVA ELENA V. , KOZYRENKO MARINA M. , TRIAS-BLASI ANNA
Published: February 2018

Historically, the species composition of Iris ser. Lacteae has been controversial. Morphological and molecular analyses have been conducted here including specimens covering most of their distribution range. The results suggest I. ser. Lacteae includes three species: the well-known I. lactea and I. oxypetala, plus a newly defined taxon which is endemic to the Gansu and Qinghai provinces, China. We here propose it as a new combination at the species rank, I. tibetica. Morphologically, this species is close to I. lactea but differs by its horizontal, creeping rhizome, scapes with no more than two flowers, its bracts reach the middle of the first flower, its broader inner perianth segments, its obovate with obtuse apex outer perianth segments, and its fruit apex always abruptly narrowed to a very short beak. The most useful qualitative and quantitative morphological characters used to distinguish this species are highlighted. Additionally, all three names are here typified, and a neotype for the name I. lactea and a lectotype for the name I. tibetica are designated. Notes on distribution and habitat are provided for all the accepted species.
The genus Tetracladium in Pampean streams (Buenos Aires, Argentina)
Authors: KRAVETZ SEBASTIÁN , GONZÁLEZ BEATRIZ , MARANO AGOSTINA , GIORGI ADONIS
Published: February 2018

Ingoldian fungi are frequently found in streams of the northern hemisphere, as well as in other regions worldwide. Even though they have high relevance as decomposers of fallen leaves, information on this group of fungi in Argentina is scarce. To assess the presence of ingoldian fungi in Pampean streams, samples of foam from 14 streams of different basins were collected. Four species and a new form of Tetracladium were recorded: Tetracladium breve, T. furcatum, T. marchalianum, T. setigerum and Tetracladium sp. Tetracladium furcatum is reported for the first time in South America, while T. breve and T. marchalianum are first records for Argentina.
Two novel species of Paradictyoarthrinium from decaying wood
Authors: LIU JIAN-KUI , LUO ZONG-LONG , LIU NING-GUO , CHEEWANGKOON RATCHADAWAN , TO-ANUN CHAIWAT
Published: February 2018

Two new hyphomycetes, Paradictyoarthrinium aquatica and P. hydei were collected and isolated from submerged wood and decaying wood in China and Thailand respectively. Morphologically, they line well with Paradictyoarthrinium in having superficial, gregarious, black, powdery fruiting bodies, macronematous conidiophores with unevenly dictyoseptate, muriform, subglobose to ellipsoidal dark brown conidia, but they differ from the other species in having short conidiophores. Phylogenetic analysis of combined LSU, ITS and RPB2 sequence data showed that six taxa of Paradictyoarthriniaceae, including the two new species, form a monotypic clade among the phylogenetically close families in Pleosporales with good support. Six isolates of Paradictyoarthrinium formed four distinct clades and represent four different species. Detailed descriptions and illustrations of the new species are provided, as well as the comparisons with related taxa.
Quantifying the Relative Importance of Direct and Indirect Biophysical Effects of Deforestation on Surface Temperature and Teleconnections
Authors: Devaraju N. , de Noblet-Ducoudré Nathalie , Quesada Benjamin , Bala G.
Published: February 2018

In this study, the authors linearize the surface energy budget equation that disentangles indirect effects (resulting from changes in downward shortwave and longwave radiation and air temperature) from direct biophysical effects (resulting from changes in surface albedo, evapotranspiration, and roughness length) of deforestation on land surface temperature. This formulation is applied to idealized deforestation simulations from two climate models and to realistic land-use and land-cover change (LULCC) simulations from 11 models, and the contribution of each underlying mechanism to surface temperature change is quantified. It is found that the boreal region experiences dominant indirect effects and the tropics experience dominant direct effects in all seasons in idealized deforestation simulations. The temperate region response differs in the two models. However, five out of seven models in response to realistic historical LULCC show a dominance of indirect effects in the temperate region. In response to future LULCC, three out of four models confirm the dominance of direct effects in the tropical region. It is found that indirect effects are always largely attributable to air temperature feedback and direct effects are essentially driven by changes in roughness length in both idealized and realistic simulations. Furthermore, teleconnections are shown to exist between deforested regions and the rest of the world, associated with the indirect effects. The study also shows that the partitioning between direct and indirect effects is highly model dependent, which may explain part of the intermodel spread found in previous studies comparing the total biophysical effects across models.
Utilization of Patient Navigators in an Urban Academic Pediatric Primary Care Practice
Authors: Sprecher Eli , Conroy Kathleen , Chan Jenny , Lakin Paul R. , Cox Joanne
Published: February 2018

Navigating health care systems can be a challenge for families. A retrospective descriptive cohort analysis was conducted assessing referrals to patient navigators (PNs) in one urban academic pediatric primary care practice. PNs tracked referral processes and a subset of PN referrals was assessed for markers of successful referrals. The most common reasons for referral were assistance overcoming barriers to care (46%), developmental concerns (38%), and adherence/care coordination concerns (14%). Significant predictors of referral were younger age, medical complexity, public insurance, male sex, and higher rates of no-show to visits in primary or subspecialist care. The majority of referrals were resolved. The referrals for process-oriented needs were significantly more successful than those for other concerns. PNs were more effective for discrete process tasks than for those that required behavior change by patients or families. Future directions include analysis of cost effectiveness of the PN program and analysis of parent and primary care provider experience.
Fractures in the Pediatric Emergency Department: Are We Considering Abuse?
Authors: Lavin Lindsay R. , Penrod Cody H. , Estrada Cristina M. , Arnold Donald H. , Saville Benjamin R. , Xu Meng , Lowen Deborah E.
Published: February 2018

Approximately one fourths of infant fractures are due to abuse. Recognition of abuse is important to avoid further morbidity/mortality. There is limited knowledge regarding how frequently pediatric emergency department clinicians consider abuse in infants with fractures. Our primary objective was to estimate the percentage of infants with fractures for whom abuse was considered, and to examine characteristics associated with abuse consideration. We performed a retrospective review of infants <1 year of age presenting to a pediatric emergency department. Our primary outcome variable was consideration of abuse. Our secondary outcome measures were identification of predictor variables associated with consideration of abuse. We identified 509 infants meeting study criteria. Pediatric emergency physicians considered abuse in approximately two thirds of infants with fractures. Consideration was more likely to occur in younger infants, in the presence of no history or unwitnessed injury mechanism, when evaluated by male physicians, and emergency department encounters from 12 am to 6 am.
Comparison of Plasma-Lyte A and Sodium Chloride 0.9% for Fluid Resuscitation of Patients With Diabetic Ketoacidosis
Authors: Oliver Wesley D. , Willis George C. , Hines Michelle C. , Hayes Bryan D.
Published: February 2018

Purpose: The aim of this study was to compare Plasma-Lyte A (PL) and sodium chloride 0.9% (NS) in regard to time to resolution of diabetic ketoacidosis (DKA) when one fluid was used predominantly over the other for resuscitation. Methods: We performed a retrospective analysis of the records of patients treated for DKA at a large, academic medical center between July 1, 2013, and July 1, 2015. Patients were placed into the PL or NS group based on the predominant fluid they received during fluid resuscitation. Serum biochemistry variables were categorized as follows: initial, 2 to 4 hours, 4 to 6 hours, 6 to 12 hours, and 12 to 24 hours. The primary outcome was mean time to resolution of DKA. Results: Eighty-four patients were included in the study. The primary outcome of mean time to resolution of DKA was similar between the PL (19.74 hours) and NS (18.05 hours) groups ( P = .5080). Patients treated with PL had a significantly greater rise in pH within the 4- to 6-hour and 6- to 12-hour periods. The chloride level was significantly higher and the anion gap was significantly lower for the NS group in the 6- to 12-hour period. Conclusion: These data suggest that the use of PL for fluid resuscitation in DKA may confer certain advantages over NS.
Back from Shingly: Revisiting the premodern history of Jews in Kerala
Authors: Gamliel Ophira
Published: February 2018

Jewish history in Kerala is based on sources mainly from the colonial period onward and mostly in European languages, failing to account for the premodern history of Jews in Kerala. These early modern sources are based on oral traditions of Paradeśi Jews in Cochin, who view the majority of Kerala Jews as inferior. Consequently, the premodern history of Kerala Jews remains untold, despite the existence of premodern sources that undermine unsupported notions about the premodern history of Kerala Jews—a Jewish ‘ur-settlement’ called Shingly in Kodungallur and a centuries-old isolation from world Jewry. This article reconstructs Jewish history in premodern Kerala solely based on premodern travelogues and literature on the one hand and on historical documents in Old Malayalam, Hebrew and Judeo-Arabic on the other hand. Sources of the early modern period are then examined for tracing the origins of the Shingly myth, arguing that the incorporation of the Shingly legend into the historiography of Kerala Jews was affected by contacts with European Jews in the Age of Discoveries rather than being a reflection of historical events.
Governance: The Concept and Its Dimensions
Authors: Sharma Arvind K.
Published: February 2018

Governance, as the term came to be used since the 1980s and the 1990s under the influence of the neo-liberals, is about a minimalist state. It seeks a state rollback on the ground that state is inherently inefficient when compared with the markets. Apart from this, since then other versions have developed, which led one commentator to say that so numerous are the definitions of governance that it has become analytically an intractable construct. This article presents its subject matter in three sections. The first section focuses on the semantics; it underlines the need to distinguish between the conventional and the neo-liberal usages of the term governance. The second section, which forms the bulk of the present article, discusses the five strands that collectively form the complex whole we call governance. The third and the concluding section contrasts the positivism of the neoclassical economics and new institutional economics, from which the neo-liberal governance paradigm is shaped, with the normative orientation of the classical school of administrative thoughts that dominated the discipline of public administration during the first fifty years (the 1887–1937 period).
Government, Governance and Good Governance
Authors: Nag Ninad Shankar
Published: February 2018

It is proposed that government, being the tangible expression of the legitimate authority within an organised society, has undegone a long transformational journey since its very emergence. The various evolutionary forms and features of the government have been the product of its meaningful and viable responses to the changing expectations of the people as well as to the challenges they faced in an ever-changing environment. The exclusive domain of the state over the period became a shared space with inclusion of other actors and stakeholders, and an era of governance was ushered in since the 1980s. The much celebrated success of the liberal democracy and its market-led open economy heralded as an era of good governance. However, the universal model of good governance fails to take into account the local constraints of a society. Thus, the idea of good governance has to face various types of challenges in the developing as well as underdeveloped societies.
Natural Disasters in India: A Comparative Study of Print Media’s Approach of Top Four English Dailies’ Coverage of Uttarakhand Floods, 2013
Authors: Giri Dhanashree , Vats Aman
Published: February 2018

Print media plays a significant role during disasters as it is one of the most widely used modes of communicating important information to the masses. Every media has different agenda to highlight in such a scenario. While some media may portray the devastation, others may expose the failures of the system. The article pursues four of the most read English newspapers in India out of which three are also local favourites of Uttarakhand, which are selected on the basis of their readership, to examine how print media disseminated the news of Uttarakhand floods 2013—whether it was playing an important role in awareness generation and mitigation or it was concerned with only reporting situational information. The authors use qualitative content analysis to map print media’s interventions during Uttarakhand disaster in 2013.

Media framed most of the Uttarakhand flood stories by stressing widely on the response and less often focusing on the level of preparedness of the community. Most of the stories covered information related to rescue operation, while very few stories concentrated upon awareness generation, mitigation and redevelopment. Often the messages conveyed by the media pertain to ‘during-disaster’ and ‘post-disaster’ phases. It is evident from this study that efforts of media are least in educating people and disseminating information on disaster before it strikes. In the concluding note, authors specify the road to better disaster management and provide an input for policymakers and media agencies for a coordinated approach.
New Public Management-based Reform in Bangladesh: A Review of Public Administration Reform Commission
Authors: Islam Md. Shariar
Published: February 2018

This article highlights that Bangladesh has not been able to achieve desired success in implementing Public Administration Reform Commission’s (PARC) new public management (NPM)-driven reform recommendations as there are major challenges such as lack of political commitment, bureaucratic unwillingness to bring about change, lack of advocacy for NPM reform among the people and inefficient public service management. To face the challenges of NPM reform implementation, it is needed to ensure political commitment, bureaucratic support, awareness among the people through government, non-government and social organisations.
Situating Tribal Women in Gender Discourse: A Study of the Socio-economic Roots of Gender Violence in Odisha
Authors: Dhal Sangita
Published: February 2018

Violence against the vulnerable sections of the society arising due to multitude factors in the era of globalisation is a serious matter of social and academic discourse. The growing incidence of violence perpetrated against women in contemporary times is a testimony to the fast-eroding idea of human security in a globalised world, which originates from the patriarchal power structure existing in the society.

Women at large are proving to be the most vulnerable section of the society, who bear the brunt of the ongoing process of social and economic transformations in the 21st century. Globalisation has presented new challenges for the realisation of the goal of women’s equality and justice, the gender impact of which has not been systematically evaluated fully. Benefits of the growing global economy are unevenly distributed leading to wide economic disparities, the feminisation of poverty, increased gender inequality through deteriorating working conditions and an unsafe working environment, especially in the rural areas. Violence against tribal women as a legitimate human rights issue is examined within four broad parameters of globalisation, development, displacement and migration.
Intercultural Competence by International Experiences? An Investigation of the Impact of Educational Stays Abroad on Intercultural Competence and Its Facets
Authors: Wolff Fabian , Borzikowsky Christoph
Published: February 2018

Intercultural competence (ICC) can be defined as a complex of abilities that are needed to interact with people from other cultures adequately and effectively. The goal of the present study was to investigate the development of ICC during international experiences. We conducted a quasi-experimental longitudinal study with a sample of N = 273 individuals. Whereas 199 participants went abroad for at least 3 months, the remaining 74 participants stayed in Germany during the same period. ICC was operationalized with the short version of the Test to Measure Intercultural Competence, which measures six facets of ICC multi-methodically with a self-appraisal test and a situational judgment test. We calculated regression analyses within the framework of change score models, thereby yielding significant increases in global ICC after 3 months abroad. Analyzing the six facets of ICC, we found the greatest increase for Cultural Identity Reflection, which is defined as intensively and constantly reflecting upon one’s own cultural character. We discuss our results with regard to the conceptualization of ICC and the relevance of stays abroad.
Mental Health Problems Among Whistleblowers: A Comparative Study
Authors: van der Velden Peter G. , Pecoraro Mauro , Houwerzijl Mijke S. , van der Meulen Erik
Published: February 2018

Whistleblowers play a very important and indispensable role in society and health care sector, but their act may elicit retaliation and other negative effects, which may impact their mental health. The main aim of the present comparative study is to assess to what extent whistleblowers ( N = 27) more often suffer from severe mental health problems than other population-based groups in the Netherlands, i.e., matched controls ( N = 135), cancer patients ( N = 130), persons with (partial) work disabilities ( N = 194), physically “healthy” persons ( N = 200), and general population ( N = 1026), using the 36-Item Short-Form Health Survey scales (for general mental health) and the Symptom Checklist-90-Revised scales (for specific mental health problems: depression, anxiety, agoraphobia, interpersonal sensitivity and distrust, and sleeping problems). Logistic regression analyses showed that the prevalence of general mental health problems was much higher than among matched controls and people with work disabilities but similar to cancer patient when controlling for demographics. About 85% suffered from severe to very severe anxiety, depression, interpersonal sensitivity and distrust, agoraphobia symptoms, and/or sleeping problems, and 48% reached clinical levels of these specific mental health problems. These specific mental health problems were much more prevalent than among the general population.
Study of knitted fabrics with ultra-low modulus based on geometrical deformation mechanism
Authors: Tian Hui , Jiang Yaming , Qi Yexiong , Xiang He , Yan Jingjing
Published: February 2018

In some cases, the value of clothing pressure on the human body is more than desired which results in discomfort, especially for those designed for infants, aged people and professionals. In order to reduce the pressure so that it is at a comfortable level, this investigation developed a knitted fabric with ultra-low modulus based on the geometrical deformation mechanism. Experimental results show that the tensile deformation is due to the geometrical deformation and physical deformation. This paper focuses on the former, which is greatly improved by reknitting of the unroved yarn with remarkable crimps. The tensile results indicate that compared with the normally rib-knitted fabric, which the elongation of the reknitted fabric reaches at 50%, the tensile modulus decreases by 96%. It is proved that increasing the geometrical deformation is an effective method for reducing the elastic modulus. In addition, the pressure of men's cotton socks and ladies' stocking and tights on skin is measured. Experimental results show that the value of the pressure is as high as 2.959 kPa, which far exceeds the comfort pressure threshold of 0.667 kPa. Furthermore, this paper also studies the application of this developed reknitted fabric. The study of geometrical deformation mechanism-based ultra-low-modulus fabrics with knitting of the yarn with remarkable crimps has important significance, and provides scientific guidance for improving clothing pressure.
Rest as a Virtue: Theological Foundations and Application to Personal and Professional Life
Authors: White Jama L. , Blackburn Amanda M. , Plisco Mary K.
Published: February 2018

In a culture that values availability, productivity, and speed, a strong work ethic is honored and rewarded. Hard work is seen as virtuous, while rest is given little attention. However, Scripture notes the value of rhythmic, intentional rest practices (i.e., Sabbath-keeping) and cultivation of a Sabbath heart. This article explores the value in rest that attends to enjoying, worshipping, and receiving from God outside of the world of performance and productivity. Consideration is given to the ways that both our culture and profession present major barriers to embracing this virtuous rest for mental health professionals. A brief survey of those with training in a mental health field who profess a Judeo-Christian worldview was conducted. Results showed that those who identified themselves as Sabbath-keepers were significantly more satisfied with the amount and quality of their rest than those who did not identify as Sabbath keepers. Future research implications are discussed.
Studying Wisdom: Toward a Christian Integrative Perspective
Authors: McLaughlin Paul , McMinn Mark R.
Published: February 2018

Wisdom is both a current topic of empirical investigation and a vital part of religious thought. What is the proper relationship between the science of wisdom and religious tradition? We suggest four possible approaches: remove the study of wisdom from its religious moorings, disregard the science of wisdom, look for commonalities in wisdom traditions, and look for particular contributions with religious faiths. Whereas the first two approaches introduce a number of problems for those committed to the integration of faith and psychology, the latter two approaches create a number of intriguing possibilities. Three potential areas of wisdom investigation are offered that fit within the fourth approach to relating wisdom and religion. Finally, a specific example of an empirical study is provided.
Compassion Development in Higher Education
Authors: Rashedi Roxanne , Plante Thomas G. , Callister Erin S.
Published: February 2018

Many schools of psychology and religious studies intend to promote the cultivation of compassion. Compassion is currently an integral area of study in psychology, religious studies, and higher education, specifically in faith-based higher education. While secular universities in the United States strive to generate disciplinary-based knowledge through scholarship, their ability to promote students’ use of the information they are learning to create positive social change has typically lagged. Conscious of the magnitude of today's global issues and dissatisfied with the current disparity between the world's reality and university curricula, scholars have begun to re-imagine the role of higher education in forming the leaders who will face our most exigent problems. The present article reviews how compassion can be integrated into university curriculum, specifically in faith-based institutions. The article also discusses how compassion can be measured throughout the course of undergraduates’ careers.
Preventing Compassion Fatigue Amongst Pastors: The Influence of Spiritual Intelligence and Intrinsic Motivation
Authors: Snelgar Robin John , Renard Michelle , Shelton Stacy
Published: February 2018

The purpose of this study was to investigate whether spiritual intelligence and intrinsic motivation can act as antecedents to compassion fatigue. This study will prove useful to pastors who wish to lower the levels of burnout and secondary traumatic stress that stem from their work in ministry. The study reviews a sample of 273 South African pastors across four denominations and demonstrates partial support for relationships between spiritual intelligence and intrinsic motivation with not only compassion fatigue, but also its factors of burnout and secondary traumatic stress. The two factors of compassion fatigue do, however, both relate positively to critical existential thinking and negatively with personal meaning production, therefore suggesting that different elements of spiritual intelligence play varying roles in reducing or aggravating compassion fatigue. Burnout can be reduced through increased intrinsic motivation to work in the ministry, and so this study provides recommendations to assist pastors in overcoming compassion fatigue.
Still Waters Run Deep: Humility as a Master Virtue
Authors: Lavelock Caroline R. , Worthington Everett L. , Griffin Brandon J. , Garthe Rachel C. , Elnasseh Aaliah , Davis Don E. , Hook Joshua N.
Published: February 2018

We present two intervention studies designed to promote humility and other virtues. In Study 1, we compared the PROVE Humility workbook (Lavelock, Worthington, & Davis, 2012/2013) to alternative workbooks, each designed to promote a particular virtue (e.g., forgiveness, patience, self-control) or mood state (positivity). Participants who completed the PROVE Humility workbook reported greater increases in humility and other virtues when compared to participants in the other conditions. In Study 2, we revised the workbook and tested it against a test-retest control condition. Study 2 replicated the findings from Study 1, such that participants who completed the PROVE Humility workbook reported improvements in humility and other virtues (e.g., forgivingness and patience), as well as reductions in negative affect. These findings support the idea of humility being a master virtue, and we recommend future directions for the clinical application of humility.
Perspectives on the Integration of Psychology and Theology
Authors: Narramore Bruce
Published: February 2018

As editor of the Journal of Psychology and Theology the author sketches the main purposes of this new publication. A statement of the goals of the editorial committee is followed by a brief evaluation of the present status of efforts to integrate biblical and psychological truth, a survey of some factors that have hindered the progress of integrative endeavors, and some suggestions for potentially fruitful areas of study and interaction.
Why Theology?
Authors: Walvoord John E.
Published: February 2018

Philosophical and theological assumptions still influence the decisions of behavioral scientists as theoreticians and therapists. The scientific method alone will never reveal the nature, richness and complexity of man and human existence. Theology offers carefully tested presuppositions which lead to a comprehensive cosmology with a distinctive view of man and reality. The questions of man's existence, meaning, spirituality and value make sense within an ordered world view based on a theocentric view of reality. Man's psychological life cannot be completely separated from his spiritual life. Psychologists who want to understand the total process of living must understand the spiritual dimension of human experience.
Worm Theology or Wormhood Feelings— Which?
Authors: Martindale George R.
Published: February 2018

One of the major objectives of the editors of the Journal of Psychology and Theology is to promote dialogue on psychological topics by evangelicals. To help achieve this objective, each issue of the Journal of Psychology and Theology will feature invited reactions to one or more of that current issue's articles. In addition to that, we encourage our readers to submit letters of reaction to past articles for publication in a Dialogue section of the Journal. This issue's Reactions are to the preceding article, “The Nature of Man and the Christian's Self Esteem” by William Counts.
A Personal Look at Paul Tournier
Authors: Collins Gary R.
Published: February 2018

On May 12, 1973, Dr. Paul Tournier will celebrate his 75th birthday. Orphaned as a young boy, he had a lonely childhood but went on to achieve world-wide fame as an author and Christian counselor. While attempts have been made to identify Tournier's most significant contributions, this article discusses three of his outstanding characteristics: A deep respect for science, a concern for individuals as persons, and a complete submission to God.
Profile: Psychology Faculty in Christian Colleges
Authors: Ellison Craig W.
Published: February 2018

A survey assessing training, background, attitudes, professional involvement, goals and activities was sent to 46 Christian colleges. A profile of psychology faculty was developed, based upon the responses of 69 faculty from 35 colleges. In addition, a roster of the psychology faculty is presented indicating degree, rank, specialization of each faculty respondent according to college.
Psychology and the Church: Toward a Model for Relating
Authors: Malony H. Newton
Published: February 2018

This essay discusses the need to define the relations between psychology and the church as more than the consultation over pastoral counseling cases. A paradigm for understanding these relationships is proposed. Definitions are given for the church and for psychology. The church is seen as a place, a plan, a program and a people. Psychology is defined as the attempt to understand, explain and influence behavior. Psychology can relate to the church by collaborating or consulting on any one of the several facets of church life. The implications of the model are suggested. Thus psychology is seen to be able to assist the church in enhancing its ministry and fulfilling its ministry.
Contract Therapy and the Christian Covenant
Authors: Tweedie Donald F.
Published: February 2018

The objections to Contract Therapy by Christian psychologists and clientele are on two levels: (a) It is a neutral, and thus secular methodology; (b) it is specifically non-Christian in both its theory and application, i.e., it is an attempt to impose law upon a relationship rather than to introduce grace; and it appeals to personal privilege and a negotiated catering to personal self-interest. It is suggested that, like any other counseling formula, Contract Therapy is non-neutral as it will tend to reflect the value system of the therapist. Also, the negotiating of a “better covenant” in marital therapy, instead of being non-Christian, is more likely to provide an atmosphere of gracious relationship that comports well with the evangel.