We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
This chapter explores the mutually constitutive relationship between the emergence of “penal populism” in fledgling democracies such as the Philippines, on one hand, and the erosion of democratic values and institutional protection of as well as societal respect for human rights, on the other. It contextualizes this phenomenon within the broader landscape of democratic retreat across “emerging market democracies” – namely rapidly growing economies with a relatively robust democratic tradition and, at least, more than a decade of competitive electoral practice – where growing dissatisfaction with unresponsive democratic institutions due to bureaucratic paralysis has gone hand in hand with the resurgence of so-called Asian values. The chapter argues that the rise of Filipino strongman Rodrigo Duterte is not only reflective of a systemic deadlock within Philippine democracy, but also the upshot of a worldwide backlash against enlightenment values. The way forward requires structural reforms in the penal system, not only to ensure the proper dispensation of justice, but also to revive public confidence in and support for due process and human rights.
In arguably his most political novel, Demons,1 Russian novelist Fyodor Dostoyevsky warned that in ‘turbulent times of upheaval or transition low characters always come to the front everywhere’. Throughout his works, but most especially in this book, Dostoyevsky was absorbed by the perils of disruptive change in the ruins of a crumbling Czarist regime, as radicals and hardliners sought to establish a brave new world in a rapidly modernising yet tempestuous milieu. Quite presciently, he foresaw the dangers of what Italian thinker Antonio Gramsci, writing half a century later, most famously described as an impossible situation whereby ‘the old [order] is dying and the new cannot be born,’ thus ‘in this interregnum, a great variety of morbid symptoms [begin to] appear’. Confronting the advent of European fascism, Gramsci warned of ‘incurable structural contradictions [that] have revealed themselves’, with mainstream ‘political forces … struggling to conserve and defend the existing structure’.2
Diagnostic ultrasound is widespread in obstetric practice, yet many babies with major congenital heart disease remain undiagnosed. Factors affecting prenatal diagnosis of major congenital heart disease are not well understood. This study aims to document prenatal detection rates for major congenital heart disease in the Greater Cincinnati area, and identify factors associated with lack of prenatal diagnosis.
Methods
All living infants diagnosed with major congenital heart disease by 4 months of age at our centre were prospectively identified. Prenatal care data were obtained by parent interview. Neonatal records were reviewed for postnatal data. Obstetricians were contacted for diagnostic ultrasound data.
Results
A total of 100 infants met the inclusion criteria. In all, 95 infants were analysed, of whom 94 were offered diagnostic ultrasound. In all, 41 had a prenatal diagnosis of major congenital heart disease. The rate of prenatal detection varied by cardiac lesion, with aortic arch abnormalities, semilunar valve abnormalities, and venous anomalies going undetected in this sample. Among subjects without prenatal detection, the highest proportion consisted of those having Level 1 diagnostic ultrasound only (66%). Prenatal detection was not significantly influenced by maternal race, education level, income, or insurance type.
Conclusions
Despite nearly universal diagnostic ultrasound, detection rates of major congenital heart disease remain low in southwest Ohio. An educational outreach programme including outflow tract sweeps for community-level obstetrical personnel may improve detection rates.
Infants with single ventricle congenital heart disease demonstrate increasing head growth after bidirectional Glenn; however, the expected growth trajectory has not been well described.
Aims:
1) We will describe the pattern of head circumference growth in the first year after bidirectional Glenn. 2) We will determine if head growth correlates with motor developmental outcomes approximately 12 months after bidirectional Glenn.
Methods:
Sixty-nine single ventricle patients underwent bidirectional Glenn between 2010 and 2016. Patients with structural brain abnormalities, grade III–IV intra-ventricular haemorrhage, significant stroke, or obstructive hydrocephalus were excluded. Head circumference and body weight measurements from clinical encounters were evaluated. Motor development was measured with Psychomotor Developmental Index of the Bayley Scales of Infant Development, Third Edition. Generalised estimating equations assessed change in head circumference z-scores from baseline (time of bidirectional Glenn) to 12 months post-surgery.
Results:
Mean age at bidirectional Glenn was 4.7 (2.3) months and mean head circumference z-score based on population-normed data was −1.13 (95% CI −1.63, −0.63). Head circumference z-score increased to 0.35 (95% CI −0.20, 0.90) (p < 0.0001) 12 months post-surgery. Accelerated head growth, defined as an increase in z-score of >1 from baseline to 12 months post-surgery, was present in 46/69 (66.7%) patients. There was no difference in motor Psychomotor Developmental Index scores between patients with and without accelerated head growth.
Conclusion:
Single ventricle patients demonstrated a significant increase in head circumference after bidirectional Glenn until 10–12 months post-surgery, at which time growth stabilised. Accelerated head growth did not predict sub-sequent motor developmental outcomes.
Recommend this
Email your librarian or administrator to recommend adding this to your organisation's collection.