Eve and the Forbidden Fruit: Reflections on a Feminist Methodology

In traditional Western legal analysis, the standard approach to dispute resolution involves evaluating the respective rights in a given conflict, and imposing an ordered settlement with one right as paramount. This method is upheld as an objective process leading to inherent truths. In reality, traditional legal approaches are steeped in subjective and normative selections. The decision-maker infuses the analysis with the values and priorities of a limited segment of the community. The consequence of this approach has been the entrenchment of legal principles which reflect traditionally male perspectives. For example, the legal approach of characterizing conflicts in terms of competing rights finds its philosophical underpinning in male approaches to reasoning. This focus on competing rights in defining and resolving conflict serves to overlook other perspectives, and ignores the realities of individuals actually before the decision-maker. In an attempt to address both the individual and collective experience, feminist legal theorists have moved beyond the constraints inherent in liberal legalism. Feminists have critiqued the rights-based approach as one which neglects to address the realities of women. The difficulties in employing a rights-based approach are evidenced in the Supreme Court of Canada\u27s decision in Re Eve, which concerned the question of contraceptive sterilization of mentally incompetent women. The Court based its decision on the parens patriae jurisdiction. Writing for the unanimous Court, Laforest, J. restricted the exercise of that jurisdiction to exclude the contraceptive sterilization of the mentally incapacitated woman before it. This decision has been hailed by many as a victory for the mentally disabled. However, the author argues that these accolades are short-sighted

Obesity Partially Mediates the Diabetogenic Effect of Lowering LDL Cholesterol

OBJECTIVE LDL cholesterol (LDLc)-lowering drugs modestly increase body weight and type 2 diabetes risk, but the extent to which the diabetogenic effect of lowering LDLc is mediated through increased BMI is unknown. RESEARCH DESIGN AND METHODS We conducted summary-level univariable and multivariable Mendelian randomization (MR) analyses in 921,908 participants to investigate the effect of lowering LDLc on type 2 diabetes risk and the proportion of this effect mediated through BMI. We used data from 92,532 participants from 14 observational studies to replicate findings in individual-level MR analyses. RESULTS A 1-SD decrease in genetically predicted LDLc was associated with increased type 2 diabetes odds (odds ratio [OR] 1.12 [95% CI 1.01, 1.24]) and BMI (b 5 0.07 SD units [95% CI 0.02, 0.12]) in univariable MR analyses. The multivariable MR analysis showed evidence of an indirect effect of lowering LDLc on type 2 diabetes through BMI (OR 1.04 [95% CI 1.01, 1.08]) with a proportion mediated of 38% of the total effect (P 5 0.03). Total and indirect effect estimates were similar across a number of sensitivity analyses. Individual-level MR analyses confirmed the indirect effect of lowering LDLc on type 2 diabetes through BMI with an estimated proportion mediated of 8% (P 5 0.04). CONCLUSIONS These findings suggest that the diabetogenic effect attributed to lowering LDLc is partially mediated through increased BMI. Our results could help advance understanding of adipose tissue and lipids in type 2 diabetes pathophysiology and inform strategies to reduce diabetes risk among individuals taking LDLc-lowering medications

Eve and the Forbidden Fruit: Reflections on a Feminist Methodology

In traditional Western legal analysis, the standard approach to dispute resolution involves evaluating the respective rights in a given conflict, and imposing an ordered settlement with one right as paramount. This method is upheld as an objective process leading to inherent truths. In reality, traditional legal approaches are steeped in subjective and normative selections. The decision-maker infuses the analysis with the values and priorities of a limited segment of the community. The consequence of this approach has been the entrenchment of legal principles which reflect traditionally male perspectives. For example, the legal approach of characterizing conflicts in terms of competing rights finds its philosophical underpinning in male approaches to reasoning. This focus on competing rights in defining and resolving conflict serves to overlook other perspectives, and ignores the realities of individuals actually before the decision-maker. In an attempt to address both the individual and collective experience, feminist legal theorists have moved beyond the constraints inherent in liberal legalism. Feminists have critiqued the rights-based approach as one which neglects to address the realities of women. The difficulties in employing a rights-based approach are evidenced in the Supreme Court of Canada\u27s decision in Re Eve, which concerned the question of contraceptive sterilization of mentally incompetent women. The Court based its decision on the parens patriae jurisdiction. Writing for the unanimous Court, Laforest, J. restricted the exercise of that jurisdiction to exclude the contraceptive sterilization of the mentally incapacitated woman before it. This decision has been hailed by many as a victory for the mentally disabled. However, the author argues that these accolades are short-sighted

Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: a population-based study, 2004-2007.

BACKGROUND: The authors consider whether differences in stage at diagnosis could explain the variation in lung cancer survival between six developed countries in 2004-2007. METHODS: Routinely collected population-based data were obtained on all adults (15-99 years) diagnosed with lung cancer in 2004-2007 and registered in regional and national cancer registries in Australia, Canada, Denmark, Norway, Sweden and the UK. Stage data for 57 352 patients were consolidated from various classification systems. Flexible parametric hazard models on the log cumulative scale were used to estimate net survival at 1 year and the excess hazard up to 18 months after diagnosis. RESULTS: Age-standardised 1-year net survival from non-small cell lung cancer ranged from 30% (UK) to 46% (Sweden). Patients in the UK and Denmark had lower survival than elsewhere, partly because of a more adverse stage distribution. However, there were also wide international differences in stage-specific survival. Net survival from TNM stage I non-small cell lung cancer was 16% lower in the UK than in Sweden, and for TNM stage IV disease survival was 10% lower. Similar patterns were found for small cell lung cancer. CONCLUSIONS: There are comparability issues when using population-based data but, even given these constraints, this study shows that, while differences in stage at diagnosis explain some of the international variation in overall lung cancer survival, wide disparities in stage-specific survival exist, suggesting that other factors are also important such as differences in treatment. Stage should be included in international cancer survival studies and the comparability of population-based data should be improved

Genetic architecture of spatial electrical biomarkers for cardiac arrhythmia and relationship with cardiovascular disease

The 3-dimensional spatial and 2-dimensional frontal QRS-T angles are measures derived from the vectorcardiogram. They are independent risk predictors for arrhythmia, but the underlying biology is unknown. Using multi-ancestry genome-wide association studies we identify 61 (58 previously unreported) loci for the spatial QRS-T angle (N = 118,780) and 11 for the frontal QRS-T angle (N = 159,715). Seven out of the 61 spatial QRS-T angle loci have not been reported for other electrocardiographic measures. Enrichments are observed in pathways related to cardiac and vascular development, muscle contraction, and hypertrophy. Pairwise genome-wide association studies with classical ECG traits identify shared genetic influences with PR interval and QRS duration. Phenome-wide scanning indicate associations with atrial fibrillation, atrioventricular block and arterial embolism and genetically determined QRS-T angle measures are associated with fascicular and bundle branch block (and also atrioventricular block for the frontal QRS-T angle). We identify potential biology involved in the QRS-T angle and their genetic relationships with cardiovascular traits and diseases, may inform future research and risk prediction