This article examines how Catholics form their consciences together in parishes particularly on topics of gender and sexuality. The data for this project stems from ethnographic observations and forty interviews from a 2010 to 2012 study of two Catholic parishes in Chicago. The first is a progressive parish promoting inclusion of gay and lesbians as well as women’s ordination. The second had a small but active Respect Life group attempting to change their parish culture to be more committed to Respect Life issues. The paper suggests that cultural inertia (or lack there of) is one mechanism that drives or halts conscience formation. These collective consciences lead to differing understandings of what it means to be Church and to be a person, and they may motivate actions to change the Catholic Church hierarchy or local parish. Forming consciences together has implications for understanding the role of culture and structure in the Catholic Church. Specifically, these formed consciences, parish cultures, and actions produce different boundaries and partnerships with the Archdiocese which determines what actions are legitimate by setting the conditions for parish actions and constraining parish actions with threats of sanction.

Introduction

Patent foramen ovale (PFO) is a common congenital cardiac abnormality and that has been associated with several disease processes including transient ischemic attacks (TIA), stroke, migraine headaches with aura, decompression sickness, platypnea-orthodeoxia syndrome, and shunt induced cyanosis. Controversy exists regarding closure of PFO as a therapeutic treatment modality for these disease processes. This review addresses the contemporary clinical indications for PFO closure. Areas covered: We conducted a comprehensive literature search of contemporary research studies focusing on randomized trials and meta-analyses comparing medical therapy and device closure of PFOs for the treatment of PFO associated clinical syndromes. We synthesized this literature into a review addressing indications for PFO closure in stroke, TIA, migraine headaches with aura, decompression sickness, platypnea-orthodeoxia syndrome, and shunt induced cyanosis. Expert commentary: Because in many PFO associated conditions it can be difficult to determine the degree to which the PFO is a causative factor in the disease process, we recommend a comprehensive diagnostic evaluation to exclude other obvious etiologies of PFO associated conditions before implicating the PFO and proceeding with closure. However in the properly selected patient population there is growing clinical experience and experimental evidence suggesting that closure of PFO is a safe and effective treatment modality.

It has been suggested that cortical entrainment plays an important role in speech perception by helping to parse the acoustic stimulus into discrete linguistic units. However, the question of whether the entrainment response to speech depends on the intelligibility of the stimulus remains open. Studies addressing this question of intelligibility have, for the most part, significantly distorted the acoustic properties of the stimulus to degrade the intelligibility of the speech stimulus, making it difficult to compare across "intelligible" and "unintelligible" conditions. To avoid these acoustic confounds, we used priming to manipulate the intelligibility of vocoded speech. We used EEG to measure the entrainment response to vocoded target sentences that are preceded by natural speech (nonvocoded) prime sentences that are either valid (match the target) or invalid (do not match the target). For unintelligible speech, valid primes have the effect of restoring intelligibility. We compared the effect of priming on the entrainment response for both 3-channel (unintelligible) and 16-channel (intelligible) speech. We observed a main effect of priming, suggesting that the entrainment response depends on prior knowledge, but not a main effect of vocoding (16 channels vs. 3 channels). Furthermore, we found no difference in the effect of priming on the entrainment response to 3-channel and 16-channel vocoded speech, suggesting that for vocoded speech, entrainment response does not depend on intelligibility.NEW & NOTEWORTHY Neural oscillations have been implicated in the parsing of speech into discrete, hierarchically organized units. Our data suggest that these oscillations track the acoustic envelope rather than more abstract linguistic properties of the speech stimulus. Our data also suggest that prior experience with the stimulus allows these oscillations to better track the stimulus envelope.

We develop a bioeconomic model to identify the cost-effective control of an invasive species (rainbow trout) to achieve a population viability goal for an endangered species (humpback chub) in the Grand Canyon of the U.S. Southwest. Solving the population viability problem is difficult since avoiding a threshold with a given confidence imposes a probabilistic restriction on joint outcomes (survival) over many periods. We develop a novel dynamic programming solution approach that is fast and forgoes the simulation method requirement of imposing structure on the policy function. We also investigate an adaptive management model that incorporates learning about uncertain biological dynamics. (JEL Q22, Q57).

Background

Ischemic cardiomyopathy is the leading cause of heart failure (HF). Most patients do not undergo coronary assessment after HF diagnosis. There are no randomized clinical trials of coronary assessment after HF diagnosis.

Methods

Using an electronic health record cohort of all individuals with HF within the San Francisco Health Network from 2001 to 2019, we identified factors associated with coronary assessment. Then, we studied the association of coronary assessment within 30 days of HF diagnosis with all-cause mortality and a composite of mortality and emergent angiography using a target trial emulation observational comparative-effectiveness approach. Target trial emulation is an approach to causal inference based on creating a hypothetical randomized clinical trial protocol and using observational data to emulate the protocol. We used propensity scores for covariate adjustment. We used national death records to improve the ascertainment of mortality and included falsification end points for the cause of death.

Results

Among 14 829 individuals with HF (median, 62 years old; 5855 [40%] women), 3987 (26.9%) ever completed coronary assessment, with 2467/13 301 (18.5%) with unknown coronary artery disease status at HF diagnosis assessed. Women, older individuals, and people without stable housing were less likely to complete coronary assessment. Among 5972 eligible persons of whom 627 underwent early elective coronary assessment, coronary assessment was associated with lower mortality (hazard ratio, 0.84 [95% CI, 0.72-0.97]; P=0.025), reduced risk of the composite outcome (hazard ratio, 0.86 [95% CI, 0.73-1.00]), higher rates of revascularization (odds ratio, 7.6 [95% CI, 5.4-10.6]), and higher use of medical therapy (odds ratio, 2.5 [95% CI, 1.7-3.6]), but not the falsification end points.

Conclusions

In a safety-net population, disparities in coronary assessment after HF diagnosis are not fully explained by coronary artery disease risk factors. Early coronary assessment is associated with improved HF outcomes possibly related to higher rates of revascularization and guideline-directed medical therapy but with low certainty that this finding is not attributable to unmeasured confounding.

Recovering endangered species populations when confronted with the threat of invasive species is an ongoing natural resource management challenge. While eradication of the invasive species is often the optimal economic solution, it may not be a feasible nor desirable management action in other cases. For example, when invasive species are desired in one area, but disperse into areas managed for endangered species, managers may be interested in persistent, but cost-effective means of managing dispersers rather than eradicating the source. In the Colorado River, a nonnative rainbow trout (Oncorhynchus mykiss) sport fishery is desired within Glen Canyon National Recreation Area, however, dispersal downriver into the Grand Canyon National Park is not desired as rainbow trout negatively affect endangered humpback chub (Gila cypha). Here, we developed a bioeconomic model incorporating population abundance goals and cost-effectiveness analyses to approximate the optimal control strategies for invasive rainbow trout conditional on achieving endangered humpback chub adult population abundance goals. Model results indicated that the most cost-effective approach to achieve target adult humpback chub abundance was a high level of rainbow trout control over moderately high rainbow trout population abundance. Adult humpback chub abundance goals were achieved at relatively low rainbow trout abundance and control measures were not cost-effective at relatively high rainbow trout abundance. Our model considered population level dynamics, species interaction and economic costs in a multi-objective decision framework to provide a preferred solution to long-run management of invasive and native species.