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March 19, 2014

In Research

Women, minority judicial nominees receive lower ratings

For more than half a century, the American Bar Association has vetted the nation’s judicial nominees, certifying candidates as “well qualified,” “qualified,” or “not qualified” and in the process rankling conservatives and liberals alike when nominees earn less than stellar marks.

A new study suggests that the sometimes controversial ratings could be tilted against minorities and women. An analysis of 1,770 district court nominations from 1960 to 2012 finds that the ABA systematically awards lower ratings to minorities and women than to white or male candidates. However, a candidate’s political ideology and whether they are a Republican or Democrat have no bearing on the influential seal of approval, the research shows.

“It is important to have the voices of women and minorities in the federal courts,” says author Maya Sen, assistant professor of political science. “We know that women and minority judges vote differently once they are on the bench. Women judges tend to be a little more liberal when it comes to sex-discrimination cases and African-American judges tend to vote a little bit differently when it comes to issues involving civil rights or affirmative action.”

“The record numbers of minority and women nominees currently having judicial candidacies derailed by this vetting process makes this a particularly pressing issue,” she writes in the paper published in the Journal of Law and Courts.

Creating federal courts that are more reflective of the U.S. population has eluded presidents and advocacy groups for decades. Of the 874 federal judges in service as of 2008, only 24 percent were women, 10 percent African American, 7 percent Hispanic, and less than 1 percent Asian American. Surprisingly, no federal judges in 2008 identified as Native American, despite the court’s involvement in interpreting federal Indian laws, writes Sen.


First-ever 3-D image created of structure beneath Sierra Negra volcano

The Sierra Negra volcano on Isabela Island in the Galápagos Archipelago.

The Galápagos Islands are home to some of the most active volcanoes in the world, with more than 50 eruptions in the last 200 years. Yet until recently, scientists knew far more about the history of finches, tortoises, and iguanas than of the volcanoes on which these unusual fauna had evolved.

Rochester research is providing a better picture of the subterranean plumbing system that feeds the Galápagos volcanoes, as well as a major difference with another Pacific Island chain—the Hawaiian Islands. The findings have been published in the Journal of Geophysical Research: Solid Earth.

“With a better understanding of what’s beneath the volcanoes, we’ll now be able to more accurately measure underground activity,” says Cynthia Ebinger, professor of earth and environmental sciences. “That should help us better anticipate earthquakes and eruptions and mitigate the hazards associated with them.”

Ebinger’s team, which included Mario Ruiz from the Instituto Geofisico Escuela Politecnica Nacional in Quito, Ecuador, buried 15 seismometers around Sierra Negra, the largest and most active volcano in the Galápagos. The equipment was used to measure the velocity and direction of different sound waves generated by earthquakes as they traveled under Sierra Negra. Since the behavior of the waves varies according to the temperature and types of material they’re passing through, the data collected allowed the researchers to construct a 3-D image of the plumbing system beneath the volcano, using a technique similar to a CAT-scan.


Study: common antidepressant effective in easing agitation in Alzheimer’s patients

Researchers at Rochester, Johns Hopkins University, and six other academic medical centers found that a high dose of a common antidepressant drug called citalopram significantly reduced agitation in patients participating in the study. 

Agitation is one of the most common reasons Alzheimer’s patients are moved out of their homes into higher levels of care. Caregivers watch as their loved ones become increasingly short tempered, physically restless, resistant to help, or verbally and physically abusive. Treatment options are limited. Antipsychotics are often prescribed, but they significantly increase a patient’s risk of a stroke, heart attack, or death.

Citalopram, sold under the brand names Celexa and Cipramil, is one of the most common antidepressants taken by older adults in America. In the study, published in the Journal of the American Medical Association, 30 milligrams of citalopram were given to 94 patients with agitation. Another group of 92 patients with the symptoms took a placebo.  At the end of the study, 40 percent of patients who took citalopram had “considerable relief” from their agitation symptoms, compared to 26 percent in the placebo group. 

In addition, caregivers of patients taking citalopram experienced reduced caregiver distress, further illustrating the clinical relevance of the treatment and its impact.

“It has been a long time since we’ve had such positive results in a field that has seen a sea of negative study results,” says Anton Porsteinsson, the William B. and Sheila Konar Professor and lead author of the study.

Researchers say further investigation is needed to determine whether a smaller dose will be as effective, given potentially concerning side effects of citalopram.


Complications following surgery predict costly readmissions

The presence—or absence—of complications following surgery is a strong indicator of which patients are likely to be readmitted to the hospital in the 30 days following their procedure, according to a study by Rochester researchers published in JAMA Surgery. Predicting which patients are most likely to experience complications using a simple online tool may allow health care professionals to flag patients at high risk of readmission in real time and alter care to reduce expensive trips back to the hospital.

The study examined more than 142,000 patients who had non-cardiac surgery using the American College of Surgeons National Surgical Quality Improvement Program database.

Currently, hospitals do not have a way to identify surgical patients who are at high risk for unplanned rehospitalizations. But, there is an online tool—the American College of Surgeons’ Surgical Risk Calculator—that allows health care professionals to enter patient information like age, body mass index, and smoking status and get an estimate of the patient’s risk of complications following surgery.

“If a patient’s predicted risk of complications is high, which we’ve shown puts them at greater risk of readmission, a physician might decide to move the patient to the intensive care unit or a step-down unit after surgery, as opposed to a regular hospital unit that manages less sick patients,” says Laurent Glance, lead study author and professor in the Departments of Anesthesiology and Public Health Sciences at the School of Medicine and Dentistry. “This information could also help with staffing. Instead of taking care of eight patients, a nurse might be assigned to monitor just two or three high-risk patients in an effort to prevent complications that could lead to more hospitalizations down the road.”


Female fertility: what’s testosterone got to do with it?

Egg being fertilized using needle
Rochester researchers suggests that male hormones help drive the development of follicles—structures that contain and ultimately release an egg that can be fertilized by a man’s sperm.

Several fertility clinics across the country are beginning to administer testosterone, either through a patch or a gel on the skin, to increase the number of eggs produced by certain women undergoing in vitro fertilization. Women are also purchasing the over-the-counter supplement DHEA, which is converted by the body into testosterone, to boost their chances of pregnancy with IVF.

A few clinical trials support the use of testosterone given through the skin, while others have shown no benefit of DHEA—also used in attempts to slow aging and enhance muscle mass—in increasing pregnancy and birth rates in women who don’t respond well to IVF therapy. Lacking a large and convincing body of data on the topic, the jury is still out as to whether male hormones such as testosterone improve female fertility.

A new Rochester study suggests that male hormones, also called androgens, help drive the development of follicles—structures that contain and ultimately release an egg that can be fertilized by a man’s sperm. Published in the Proceedings of the National Academy of Sciences, the research also details how male hormones boost the production of follicles in mice. Authors believe the study provides potential biological targets to enhance fertility in women with diminished ovarian reserve, who produce few or no follicles in response to IVF drugs designed to boost follicle development.

“There is a raging debate in the reproductive endocrinology field about what male hormones are doing in female fertility,” says Stephen Hammes, senior study author and professor of endocrinology at the School of Medicine and Dentistry. “Our study doesn’t solve the controversy, but, along with some earlier seminal studies from other groups, it does tell us that we can’t dismiss male hormones. They might actually be doing something useful.”


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