Nonstationary streamflow effects on backwater flood management of the Atchafalaya Basin, USA.

A non-stationary increasing streamflow trend has been observed on the Mississippi River and other major river basins around the world. The current study analyzed the non-stationary streamflow effects (NSFEs) on flood management in backwater areas adjacent to the Atchafalaya Basin floodway in Louisiana, USA. A continuous simulation hydrology model coupled with a quasi-two-dimensional hydrodynamic model of the basin floodway and surrounding regions was used to develop over 180 simulation scenarios by superimposing local flood events (early summer 2014 and late summer 2016) against 90-years' worth of daily Atchafalaya River streamflow hydrographs. The NSFE on the Atchafalaya River induced substantial reductions in the performance of major flood regulating structures with seasonal effects based on the annual flood cycle. Capacity reductions at the structures were demonstrated to trigger a cascade of effects in ostensibly protected backwater areas including amplification of erosion potential near the levee and within tidal passes during early summer floods. Increases in mean and peak flood levels on the order of 15-20 cm during local storm events were shown to extend as far as 20 km away from the floodway protection levee during both early and late summer local flooding scenarios. Low-lying areas closest to the levee were adversely affected during both the high (early summer) and low flow (late summer) periods of the annual discharge cycle. The approach and findings of this study are relevant for risk management in river basins around the world affected by NSFEs.

"Agape love is justice": Black clergies' public and theological support of Black gay men.

This study explored how 60 Black clergy came to publicly and theologically support Black gay men. They participated in three 90-minute life history interviews to address the study aims. Open, axial and selective coding were used to understand and order themes within their accounts while addressing specific aims. Life events, purpose-driven theological training and a commitment to justice provide the basis for theological and public support of Black gay men. Clergies' understanding of justice is an expression of agape love. Such love inspires both the support and advocacy of stigmatised, marginalised and overly burdened populations. Study findings question monolithic understandings of both Black clergy and the Black church as homophobic and heteronormative. The informants' data reveal agape love as a key motivation of ministerial holistic support for marginalised and oppressed populations, including Black gay men. Finally, these data assert that agape love is inconsistent with heteronomative and homophobic scriptural interpretation.

Predicting complications in hepatic resection for colorectal liver metastasis: the lymphocyte-to-monocyte ratio.

BACKGROUND: Colorectal cancer is one of the most common malignancies worldwide; whilst approximately 20% of patients have hepatic disease at presentation. Hepatic resection remains the gold standard of care; however, it is associated with significant morbidity. We sought to establish whether the lymphocyte-to-monocyte ratio (LMR) could help predict post-operative complications, thus improving patient outcomes. METHODS: We performed a retrospective cohort study of patients undergoing hepatic resection at a single centre. Baseline demographics and complications within 30 days following surgery were recorded. White blood cell counts and C-reactive protein (CRP) were recorded pre-operatively, and until post-operative day 7. RESULTS: A total of 188 operations were included. About 47.3% of resections had a complicated recovery, of which 31.46% were major. The median LMR was 1.29 across the cohort, 1.60 for uncomplicated procedures, 1.14 for those with complications and 0.85 in major complications. For detecting major complications versus an uncomplicated recovery, median LMR was the best parameter (area under the curve 0.78), whilst it was the only parameter to accurately predict such complications within 48 hours of surgery (area under the curve 0.72 on day 1). It was consistently the most accurate parameter at detecting uncomplicated versus complicated recovery, minor versus major complications, and major complications versus an uncomplicated recovery, at numerous timepoints over the post-operative period. CONCLUSION: The LMR appears better at predicting complications following hepatic resection for colorectal liver metastases, as opposed to conventionally measured parameters.

A rock in a weary land: AIDS, South Africa, and the church.

This article explores the contributing factors to the endemic problems exacerbating the AIDS crisis in South Africa. The legacy of Apartheid, including the attendant problems of poverty, illiteracy, and disparate health statuses between the beneficiaries and victims of Apartheid, is explored. Because women are bearing the brunt of the infection, their experience of AIDS is also considered. A brief case study illuminating an AIDS-sensitive church is offered as an exemplar of self-determination and social networks used to sustain a South African township riddled by HIV disease. The article concludes by suggesting that the benefits of communal religious participation as a coping response to HIV disease requires further examination by social work and public health workers in South African communities of color with minimal resources to combat HIV disease.

Legacy denied: African American gay men, AIDS, and the black church.

This qualitative study explores the religious development and spiritual formation of African American gay men living with AIDS. In response to an in-depth interviewing approach, 10 men described their experiences of church participation. The participants' data reveal their religious initiation and participation as well as their need to extinguish their affiliation with the black church as a result of religiously sanctioned homophobia, heterosexism, and AIDS phobia. The article also explores the conundrum of an African American religious organization engaging in oppression despite its historic role of supporting liberation and opposing discrimination.

An appointment with god: AIDS, place, and spirituality.

This article describes how an African American gay man living with AIDS used his spiritual, religious, and cultural strengths to resist internalized dislocation because of heterosexism and homophobia. He was able to experience a relocation of God from places that rejected him to places that were conducive to his healing. By using these strengths, he was able to reject his physician's prediction of death and to call on God in response to an end-stage AIDS crisis. The development of spiritual agency is addressed.

Potential Consequences of the Clean Coal Program for Air and Waste Issues.

The U.S. Department of Energy's Clean Coal Technology Demonstration Program (CCTDP) was funded by Congress to demonstrate more efficient, economically feasible, and environmentally acceptable coal technologies. Although the environmental focus at first was on sulfur dioxide (SO2) and nitrogen oxides (NOX) because of their relationship to acid precipitation, the CCTDP may also lead to reductions in carbon dioxide (CO2) emissions and in solid waste produced, relative to conventional technologies. Environmental benefits that maybe realized from clean coal technologies (CCTs) will depend upon the degree of acceptance in the marketplace achieved by each of the individual technologies. In general, technologies that replace a major portion of an existing facility (repowering technologies) show the most promise for achieving reductions in all four categories (SO2, NOX, CO2, and solid waste). Technologies that modify existing facilities by adding environmental control equipment or changing feedstocks (retrofit technologies), used singly or in combination, appear capable of achieving substantial reductions in SO2 and NOX, but in general have little effect on CO2, and only a few of these technologies appear capable of reducing solid waste. However, even if decreases in solid waste volume are not always achieved, much of the solid waste from CCTs would be dry and therefore easier to dispose of than scrubber sludge from conventional technologies.