“Advice and Consent” in Historical Perspective

In recent years, commentators have complained about what they regard as an increasingly dysfunctional confirmation process for judges and high-ranking executive officials, and the proper role for the Senate in the confirmation process has been much debated. This Article suggests that confirmations have been contentious throughout American history, and that the focus on ideological issues in today’s confirmation proceedings is not anomalous. Indeed, historically, both Republicans and Democrats have used the confirmation process to delay or oppose nominations when the President hails from a different political party, and, sometimes, even when the President comes from the same party but there are ideological objections to the nominee. That the appointments process has, at times, been difficult and contentious should come as no great surprise. The Framers of the United States Constitution intentionally created a governmental structure that was more prone to obstructionism than other comparable systems. Relying on concepts like “separation of powers,” and “checks and balances,” the Framers sought to constrain the federal government in ways that would limit the possibilities for governmental abuse. The appointments power reflects this approach. Like many other constitutional powers, it is a shared power. Although the President has the power to nominate Article III judges, as well as ambassadors and “officers,” nominees can only be confirmed with the “advice and consent” of the Senate. By placing the power to appoint in two politically elected entities, the Constitution establishes a system whereby political influences will sometimes have a major impact on the confirmation process. Although contentiousness can arise during any type of nomination, some Supreme Court nominations have been particularly bitter. Both the Senate and the American public have increasingly become aware that the courts make law and that the political and judicial attitudes of nominees matter. Under such circumstances, the Senate’s inquiry quite naturally goes beyond the simple question of whether a nominee is qualified or unqualified. However, the confirmation process is more difficult today, even for nonjudicial nominees, because of the bitter partisanship that has infected the U.S. political system

Monitoring of β-D-galactosidase activity as a surrogate parameter for rapid detection of sewage contamination in urban recreational water

-Abstract: Simple, automated methods are required for rapid detection of wastewater contamination in urban recreational water. The activity of the enzyme b-D-galactosidase (GAL) can rapidly (<2 h) be measured by field instruments, or a fully automated instrument, and was evaluated as a potential surrogate parameter for estimating the level of fecal contamination in urban waters. The GAL-activity in rivers, affected by combined sewer overflows, increased significantly during heavy rainfall, and the increase in GAL-activity correlated well with the increase in fecal indicator bacteria. The GAL activity in human feces (n = 14) was high (mean activity 7 b 107 ppb MU/hour) and stable (1 LOG10 variation), while the numbers of Escherichia coli and intestinal enterococci varied by >5 LOG10. Furthermore, the GAL-activity per gram feces from birds, sheep and cattle was 2–3 LOG10 lower than the activity from human feces, indicating that high GAL-activity in water may reflect human fecal pollution more than the total fecal pollution. The rapid method can only be used to quantify high levels of human fecal pollution, corresponding to about 0.1 mg human feces/liter (or 103 E. coli/100 mL), since below this limit GAL-activity from non-fecal environmental sources may interfere

Effect of maternal age on maternal and neonatal outcomes after assisted reproductive technology

Objective: To compare the effect of maternal age on assisted reproductive technology (ART) and spontaneous conception (SC) pregnancies regarding maternal and neonatal complications. Design: Nordic retrospective population-based cohort study. Data from national ART registries were cross-linked with national medical birth registries. Setting: Not applicable. Patient(s): A total of 300,085 singleton deliveries: 39,919 after ART and 260,166 after SC. Intervention(s): None. Main Outcome Measure(s): Hypertensive disorders in pregnancy (HDP), placenta previa, cesarean delivery, preterm birth (PTB; = 28 weeks). Adjusted odds ratios (AORs) were calculated. Associations between maternal age and outcomes were analyzed. Result(s): The risk of placenta previa (AOR 4.11-6.05), cesarean delivery (AOR 1.18-1.50), PTB (AOR 1.23-2.19), and LBW (AOR 1.44-2.35) was significantly higher in ART than in SC pregnancies for most maternal ages. In both ART and SC pregnancies, the risk of HDP, placenta previa, cesarean delivery, PTB, LBW, and SGA changed significantly with age. The AORs for adverse neonatal outcomes at advanced maternal age (>35 years) showed a greater increase in SC than in ART. The change in risk with age did not differ between ART and SC for maternal outcomes at advanced maternal age. Conclusion(s): Having singleton conceptions after ART results in higher maternal and neonatal outcome risks overall, but the impact of age seems to be more pronounced in couples conceiving spontaneously. (C) 2016 by American Society for Reproductive Medicine.Peer reviewe

Consumption of Meat, Fish, Dairy Products, and Eggs and Risk of Ischemic Heart Disease.

BACKGROUND: There is uncertainty about the relevance of animal foods to the pathogenesis of ischemic heart disease (IHD). We examined meat, fish, dairy products, and eggs and risk for IHD in the pan-European EPIC cohort (European Prospective Investigation Into Cancer and Nutrition). METHODS: In this prospective study of 409 885 men and women in 9 European countries, diet was assessed with validated questionnaires and calibrated with 24-hour recalls. Lipids and blood pressure were measured in a subsample. During a mean of 12.6 years of follow-up, 7198 participants had a myocardial infarction or died of IHD. The relationships of animal foods with risk were examined with Cox regression with adjustment for other animal foods and relevant covariates. RESULTS: The hazard ratio (HR) for IHD was 1.19 (95% CI, 1.06-1.33) for a 100-g/d increment in intake of red and processed meat, and this remained significant after exclusion of the first 4 years of follow-up (HR, 1.25 [95% CI, 1.09-1.42]). Risk was inversely associated with intakes of yogurt (HR, 0.93 [95% CI, 0.89-0.98] per 100-g/d increment), cheese (HR, 0.92 [95% CI, 0.86-0.98] per 30-g/d increment), and eggs (HR, 0.93 [95% CI, 0.88-0.99] per 20-g/d increment); the associations with yogurt and eggs were attenuated and nonsignificant after exclusion of the first 4 years of follow-up. Risk was not significantly associated with intakes of poultry, fish, or milk. In analyses modeling dietary substitutions, replacement of 100 kcal/d from red and processed meat with 100 kcal/d from fatty fish, yogurt, cheese, or eggs was associated with ≈20% lower risk of IHD. Consumption of red and processed meat was positively associated with serum non-high-density lipoprotein cholesterol concentration and systolic blood pressure, and consumption of cheese was inversely associated with serum non-high-density lipoprotein cholesterol. CONCLUSIONS: Risk for IHD was positively associated with consumption of red and processed meat and inversely associated with consumption of yogurt, cheese, and eggs, although the associations with yogurt and eggs may be influenced by reverse causation bias. It is not clear whether the associations with red and processed meat and cheese reflect causality, but they were consistent with the associations of these foods with plasma non-high-density lipoprotein cholesterol and for red and processed meat with systolic blood pressure, which could mediate such effects.Analyses supported by the UK Medical Research Council (MR/M012190/1), Cancer Research UK (C8221/A19170 and 570/A16491), and the Wellcome Trust (Our Planet Our Health, Livestock Environment and People 205212/Z/16/Z). EPIC-CVD has been supported by the European Union Framework 7 (HEALTH-F2-2012-279233), the European Research Council (268834), the UK Medical Research Council (G0800270 and MR/L003120/1), the British Heart Foundation (SP/09/002 and RG/08/014 and RG13/13/30194), and the UK National Institute of Health Research. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l’Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF), Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Italian Association for Research on Cancer (AIRC), National Research Council (Italy) and MIUR "Dipartimenti di Eccellenza"(Project D15D18000410001) to the Department of Medical Sciences (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF); Health Research Fund (FIS), PI13/00061 to Granada, PI13/01162 to EPIC-Murcia, Regional Governments of Andalucía, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPICNorfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), UK Medical Research Council (1000143 to EPIC-Norfolk, MR/M012190/1 to EPIC-Oxford, MC_UU_12015/1 (CL, NJW), and MC_UU_12015/5 (NF), and NIHR Biomedical Research Centre Cambridge: Nutrition, Diet, and Lifestyle Research Theme (IS-BRC-1215-20014) to the MRC Epidemiology Unit Cambridge. Kathryn Bradbury holds the Girdlers’ New Zealand Health Research Council Fellowship. Marinka Steur received Core MRC Unit support through the Nutritional Epidemiology Programme (MC_UU_12015/5) whilst at the MRC Epidemiology Unit, and received funding from the Alpro Foundation whilst at the Cardiovascular Epidemiology Unit. JD holds a BHF Professorship, NIHR Senior Investigator Award, and ERC Senior Investigator Award. The funders play no role in the design of the study; the collection, analysis, and interpretation of the data; or the decision to approve publication of the finished manuscript. The authors assume full responsibility for analyses and interpretation of these data

Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients : a cohort study

Background: Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality. The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR recommendations and mortality in colorectal cancer (CRC) patients. Methods: The association between the WCRF/AICR score (score range 0-6 in men and 0-7 in women; higher scores indicate greater concordance) assessed on average 6.4 years before diagnosis and CRC-specific (n = 872) and overall mortality (n = 1,113) was prospectively examined among 3,292 participants diagnosed with CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (mean follow-up time after diagnosis 4.2 years). Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. Results: The HRs (95% CIs) for CRC-specific mortality among participants in the second (score range in men/women: 2.25-2.75/3.25-3.75), third (3-3.75/4-4.75), and fourth (4-6/5-7) categories of the score were 0.87 (0.72-1.06), 0.74 (0.61-0.90), and 0.70 (0.56-0.89), respectively (P for trend Conclusions: Greater concordance with the WCRF/AICR recommendations on diet, physical activity, and body fatness prior to CRC diagnosis is associated with improved survival among CRC patients.Peer reviewe

Lower Urinary Tract symptoms in women - aspects on epidemiology and treatment

Lower urinary tract symptoms in women – aspects on epidemiology and treatment Lower urinary tract symptoms (LUTS) are common conditions that compromise a person’s quality of life and result in increased health care costs for society. The aims of this thesis were to describe the prevalence and natural course of different LUTS in women (Paper I), to assess prevalence changes over time (Paper II), and to evaluate the importance of genetic factors on LUTS (Paper III). The long-term results of the Stamey needle colposuspension for female stress urinary incontinence were also assessed (Paper IV). Paper I: In this population-based, longitudinal study the very same women (n=1081) were assessed regarding the prevalence, progression and remission of various LUTS in 1991 and 2007, using a postal questionnaire. The proportion of women reporting urinary incontinence (UI), overactive bladder (OAB), nocturia and daytime voiding frequency of ≥8 times/day increased markedly over time. Both incidence and remission for most symptoms were considerable. Paper II: The prevalence of LUTS, help-seeking behaviour, treatment and quality of life were compared in two population-based surveys of women performed in 1991 (n=2911) and 2007 (n=3158) using a similar questionnaire. The reported prevalence of UI and OAB was unchanged over time as was help-seeking due to UI. In 2007, more women stated that the presence of UI limited their daily life. Paper III: Questionnaire-based national cohort survey evaluating the prevalence of LUTS in Swedish twins born 1959-1985 (n=25 364). Heritability was assessed in female twins. LUTS were more common in women than in men. The strongest genetic effects were observed for UI and nocturia and the lowest for OAB without incontinence where environmental effects dominated. Shared environment accounted for nearly one third of the total variation for OAB without incontinence and for one fifth of the variation for stress UI. Non-shared environmental effects were in the range of 45-65% for the various LUTS. Paper IV: Twenty-four women, treated by the Stamey method for stress UI, were followed up by means of a questionnaire, urodynamic assessment and a standardised quantification test. Time to follow-up was 63 months. Approximately half of the women considered themselves continent at follow-up. The mean postoperative leakage was significantly reduced as compared to preoperatively. Most women were satisfied with the result of the operation. Conclusions: These studies showed that the prevalence of UI and OAB in women has been largely unchanged in the last 16 years. UI, OAB and other LUTS constitute dynamic conditions. The prevalence of symptoms increases with increasing age, but both progression and remission over time are common. The strongest genetic effects were observed for conditions involving UI and for nocturia while the lowest genetic effects were observed for OAB, where environmental factors were more important. The Stamey procedure may be used in a selected group of women with genuine stress UI and stable detrusor with acceptable long-term results and patient satisfaction

Wellbeing and Gender Equality for the Elderly in the Context of Arctic Sweden

One theme of importance for gender equality in the Arctic region is the wellbeing of the aging population and how their needs are provided for in private and public spheres –by the family, local communities, the state and the market. In this article, the complexity of the public and private division of welfare provision and care of the elderly in the Swedish Arctic context is addressed and discussed in the light of national, regional and international policy and law. Norrbotten, the northernmost county in Sweden that is part of the Barents Euro-Arctic region, is taken as a frame of reference for critical reflection on wellbeing and gender equality for the ageing population in rural, depopulated and multicultural contexts and the need to develop alternative political and legal interventions that are better adjusted to meet the everyday needs in this specific setting

Constructions of Normality and the Boundaries of Social Citizenship : Solo Mothers in the Swedish Welfare Model

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