Responsible and responsive knowing in medical diagnosis: the medical gaze revisited

The medical gaze has long been privileged over the voice of the patient as the source of medical knowledge, in western societies. The ontology (that is, the very existence) of symptoms invisible to scientific observation will thus tend to be questioned by medical professionals. Yet any gaze, even the medical one, is refracted through the lenses both of social‐cultural stereotypes and of gender, and its seeings are shaped by these refractions. In this article, two family physicians and an epistemologist examine certain “unexplained” disorders, in a conversation informed by a feminist perspective: they bring a feminist point of view to bear on these issues. Medically unexplained disorders, which occur most frequently in women, are disabling conditions for which objectively observable symptoms and/or scientific causal explanations are not available. The approach taken in this article makes some of the assumptions underlying clinical knowledge more clearly visible: the authors' conversation situates diagnostic activity in medicine as a gendered, power‐infused social interaction within a cultural context where the gold standard of medical knowledge is very narrowly set. The participants propose responsible and responsive knowing as alternative strategies for knowing well. As they are presented here, these strategies incorporate an awareness of the inherent uncertainty of medical knowledge, raise questions about those to whom the knower is accountable, acknowledge the patient's experiences, and attend to the potentially oppressive effects of expert knowing.     

Family Cohesion and Romantic and Sexual Initiation: A Three Wave Longitudinal Study

Although the relation between family relationships and the timing of sexual debut has been the focus of many studies, research on mediating factors is scarce. This study examines whether low levels of family cohesion result in an earlier onset of romantic and sexual experiences, and whether the link between family cohesion and an early sexual debut is mediated by early romantic initiation. A longitudinal sample of 314 adolescent girls and 222 boys, aged 12–17 at Wave 1, completed questionnaires at three measurement points with three year intervals. The results showed that sexual debut followed romantic initiation for 77% of the participants. For early adolescent females (aged 12–14), high levels of family cohesion resulted in a later sexual debut and this association was fully mediated by a delay of romantic initiation. Among boys and older girls, timing of romantic initiation did not mediate the link between family cohesion and timing of sexual initiation. Early adolescent girls who have negative relationships with their parents turn to romantic relationships for intimacy and support, which subsequently provide the opportunity for an early sexual debut. Low levels of family cohesion thus primarily precipitate romantic initiation and sexual initiation appears to be secondary to this process among girls in this age group.     

An Exploration of Religion and Education in the Life of Constance Maynard,Mistress of Westfield College

This article provides an overview of the motivation for digitising Maynard's writings, evaluates the benefits and challenges of reproducing and publishing archives, and considers the implications of greater digitisation. Maynard's writings reveal that she drew on her evangelical belief system as a means of protection and inspiration, and never overcame the concerns of early educationalists to maintain ‘decorum’ and ‘femininity’ in the management of the college. Published and unpublished sources are considered to review Maynard's decision to enter higher education, the inspiration for a Christian college for women, impact of contemporary arguments opposing education for women on Maynard and Westfield College, and Maynard's reaction to the development of a science faculty in the early twentieth century.     

Understanding food security and international security links in the context of climate change

Food production has been changing significantly in recent years as a result of climate change and of growing demand for food. This article aims to understand the link between food security and international security in the context of climate change, applying a systematic and qualitative analysis of the literature using the bibliometric method. This research observes that climate change tends to affect agricultural productivity, exposing societies to risk and the need for migration. However, good governance, together with international cooperation, can reduce the hazards of food insecurity, strengthening ties between countries and stimulating a fairer and more inclusive form of international trade.     

W.A. Schabas,Nowak’s CCPR Commentary: U.N. Covenant on Civil and Political Rights, 3rd rev. edn.

Netherlands International Law Review -     

Covid-19 Pandemic,Social Mitigation and Taxation: The Open Veins of Inequality in Latin America

The pandemic of Covid-19 has exposed the veins of inequality in Latin America. With a socioeconomic disaster looming, social emergency policies seemed inevitable. Yet while governments argue over the continuity of such policies and whether the fiscal rules in place should be respected, no sustainable response has come out. This essay problematises whether the pandemic could represent a critical juncture to forge ahead with political narratives that highlight tax exemptions and privileges enjoyed by the rich. We analyse the mitigation measures adopted by Argentina, Brazil, Chile and Uruguay and their repercussions on the debate surrounding progressive tax reforms to fund social schemes.     

Whole Plastome Sequences of Two Drug-Type Cannabis: Insights Into the Use of Plastid in Forensic Analyses

DNA is one of the fastest growing tools in forensic sciences, increasing reliability in forensic reports and judgments. The use of DNA has increased in different areas of the forensic sciences, such as investigation of plant species, where plastid DNA has been used to elucidate and generate evidence in cases of traceability of genetically modified and controlled plants. Even with several advances and the practice of using DNA in forensic investigations, there are just few studies related to the identification of genetic tools for the characterization of drug and nondrug-types of Cannabis. Herein, the whole plastomes of two drug-type Cannabis are presented and have their structures compared with other Cannabis plastomes deposited in the GenBank, focusing in the forensic use of plastome sequences. The plastomes of Cannabis sativa “Brazuka” and of the hybrid Cannabis AK Royal Automatic presented general structure that does not differs from the reported for other C. sativa cultivars. A phylogenomic analyses grouped C. sativa “Brazuka” with the nondrug C. sativa cultivars, while the hybrid Cannabis AK Royal Automatic placed isolated, basal to this group. This suggests that the analysis of plastomes is useful toward genetic identification of hybrids in relation to C. sativa.     

Analyzing block randomized studies: the example of the Jersey City drug market analysis experiment

Objectives

While block randomized designs have become more common in place-based policing studies, there has been relatively little discussion of the assumptions employed and their implications for statistical analysis. Our paper seeks to illustrate these assumptions, and controversy regarding statistical approaches, in the context of one of the first block randomized studies in criminal justice—the Jersey City Drug Market Analysis Project (DMAP).

Methods

Using DMAP data, we show that there are multiple approaches that can be used in analyzing block randomized designs, and that those approaches will yield differing estimates of statistical significance. We develop outcomes using both models with and without interaction, and utilizing both Type I and Type III sums-of-squares approaches. We also examine the impacts of using randomization inference, an approach for estimating p values not based on approximations using normal distribution theory, to adjust for possible small N biases in estimating standard errors.

Results

The assumptions used for identifying the analytic approach produce a comparatively wide range of p values for the main DMAP program impacts on hot spots. Nonetheless, the overall conclusions drawn from our re-analysis remain consistent with the original analyses, albeit with more caution. Results were similar to the original analyses under different specifications supporting the identification of diffusion of benefits effects to nearby areas.

Conclusions

The major contribution of our article is to clarify statistical modeling in unbalanced block randomized studies. The introduction of blocking adds complexity to the models that are estimated, and care must be taken when including interaction effects in models, whether they are ANOVA models or regression models. Researchers need to recognize this complexity and provide transparent and alternative estimates of study outcomes.