Lack Of Consent Research Articles

Elliptical excision and primary closure of nasal defect to achieve best esthetic outcome: A case series of 50 patients.

To evaluate the cosmetic result of nasal of an elliptical excision and primary closure on small nasal defect by using Scar assessment using the Stony Brook Scar Evaluation Scale (SBSES) score. This retrospective interventional study was conducted in a private clinic over a 2-year duration. Patients aged 18-60 years with nasal defects <1.5 cm were enrolled after obtaining informed consent. Exclusion criteria included immunocompromised status, keloidal tendency, local site infection, bleeding disorder, age <18 years, and lack of consent. Scar assessment using the SBSES was performed at the end of 6 months. Statistical analysis included summary statistics, analysis of variance tests, and a significance level of P < 0.05. The study included 50 patients, with 54% males and 46% females. The most common age group was 21-40 years, and melanocytic nevi was the most common cause for excision. Lesions were excised mainly from the lateral wall and dorsum of the nose. The mean SBSES score was 3.79 ± 0.467. The best cosmetic outcome was observed in lesions involving the dorsum followed by the root of the nose. No significant difference was found among the SBSES scores for various subunits. Elliptical excision with primary closure is a simple and effective technique for small nasal defects, providing good cosmetic results. The location of the nasal defect influences the cosmetic outcome, with better results observed in areas with thinner skin and increased skin laxity.

Factors Affecting the Effectiveness of DIBH (Deep Inspiratory Breath Hold) in Patients with Left Breast Cancer: A Narrative Review

Deep Inspiratory Breath Hold (DIBH) has become a valuable technique in left-breast cancer radiotherapy, offering the possibility to reduce radiation exposure to organs at risks (OARs) and minimize the risk of cardiac complications. This treatment method involves stopping the breathing of patients during irradiation in order to temporarily distance the heart from the radiation field, which reduces potential cardiac risks and other complications. To identify factors that may affect the effectiveness of DIBH treatment, we analyzed the most important 5-year studies published in the PubMed database. Research shows that DIBH reduces the radiation dose to the heart and lungs. However, the effectiveness of DIBH is determined by a variety of factors, including the patient’s training, cooperation, anatomical features, age, and choice of radiotherapy technique. Additionally, cardiovascular risk factors, such as diabetes, smoking, and hypertension, can be impactful to the effectiveness and potential complications of DIBH. Moreover, if a patient has a substantial level of depression or anxiety, then they may be potentially disqualified from the DIBH treatment method. In addition to this, a lack of consent and/or fear may also disqualify a patient from DIBH treatment. Careful patient selection, comprehensive training, and optimization of treatment parameters are essential to maximize the benefits of DIBH whilst minimizing any potential side effects. DIBH enhancement techniques, such as IMRT and VMAT, also have an important role to play. The purpose of this narrative review article is to summarize the factors affecting the efficacy and side effects of DIBH in radiation therapy for left-breast cancer, with the aim of optimizing its clinical application while minimizing side effects. Patients who are likely to benefit most from DIBH are young women in good medical condition, able to cooperate with the procedure, and with smaller breasts. The increase in the estimated 10-year patient survival is significantly influenced by cardiovascular problems, so patients without diabetes and metabolic syndrome, and non-smokers, will benefit the most. An estimated 50–70% of breast cancer patients are likely to benefit from DIBH, and in the best case, it can result in a 50% reduction in the risk of cardiac problems after photodynamic therapy (PDT).

Giving Meaning to Consent at the International Criminal Court and Beyond: A (Qualified) Defence of Consent

ABSTRACT This article examines the concept of consent in the context of rape and sexual violence within the framework of the International Criminal Court (ICC). Lack of consent is not required to be proven in relation to charges of rape in the Rome Statute, an aspect praised by feminist legal scholar Catharine MacKinnon. A significant and contested feature of MacKinnon’s theorisation of rape is her argument that such a standard should also serve as a model for domestic laws. However, it is not clear that the ICC’s current framework regarding consent and the means to address sexual violence is as robust as MacKinnon suggests. Importantly, our analysis of the international experience takes place against a backdrop where in many domestic jurisdictions consent remains firmly entrenched in law reform efforts to address the ubiquity of sexual violence. Drawing primarily on recent law reform examples from Australia, where the trend has been toward affirmative models of consent, we consider how consent is positioned within them. We argue that consent still has a place in measures in both domestic and international jurisdictions aimed at addressing the structural inequalities and power dynamics underpinning sexual violence, MacKinnon’s privileging of the measures in the international jurisdiction notwithstanding.

Antinatalist procreationism and humanity's cosmic significance

In this article, I explore several prominent arguments forwarded by advocates of the antinatalist philosophy. Mainly, I assess the asymmetry argument, the argument concerning the lack of consent by future individuals, the arguments about the quality and meaning of life, and the imposition argument. After identifying some issues with the asymmetry argument and underscoring the strengths of the other arguments, I propose a form of antinatalism that accepts procreation under narrowly defined circumstances to avert species extinction and its potentially catastrophic consequences from a cosmic perspective.

Concordance Rate of Pre-Operative Radiological Stage with Postoperative Pathological Stage in Colon Cancer

Aim: This study aimed to assess the concordance rate between pre-operative radiological staging using CT imaging and postoperative pathological staging in patients with colon cancer. Methodology: A prospective observational study was conducted at the Oncology Department of Jinnah Postgraduate Medical Center, Pakistan, with ethical committee approval between February 2023 to July 2023. Inclusion criteria involved patients diagnosed with colon adenocarcinoma aged &gt;18 receiving treatment at the center, while exclusion criteria comprised unconfirmed colon cancer, lack of consent, benign colonic polyps, metastatic cancer, chemotherapy recipients, and incomplete data. Sample size estimation yielded 227 patients. Recruitment used consecutive sampling, and data were collected using a predefined proforma. CT scans were performed, and T-stage was assessed by radiologists and pathologists. Histological analysis followed established guidelines, with final pathology serving as the gold standard. Results: The diagnostic accuracy of CT imaging was evaluated, with statistically significant concordance found between CT scans and histopathological diagnoses (p-value = 0.046). CT scans demonstrated a sensitivity of 57.14% for Stage I tumors and a specificity of 88.18% for Stage II-III tumors. The positive predictive value (PPV) was 13.3%, and the negative predictive value (NPV) was 98.48%, resulting in an overall accuracy of 87.22%. These findings suggest that CT imaging is valuable for identifying Stage II-III tumors, exhibiting good specificity and NPV, although sensitivity and PPV for Stage I tumors were comparatively lower. Chi-square testing confirmed the statistical significance of these results (p-value ≤ 0.05) Conclusion: This study highlights the utility of CT imaging in pre-operative staging of colon cancer, particularly for Stage II-III tumors, where it exhibits notable accuracy. However, improvements may be needed to enhance sensitivity and PPV for Stage I tumors. Keywords: Colon cancer, CT imaging, pathological staging, concordance rate, diagnostic accuracy.

Comparison Efficacy between Percutaneous Nephrostomy and Double J Stent in Management of Obstructive Uropathy

Background: The prevalence of urolithiasis and associated acute kidney injury (AKI) has seen a notable increase in recent decades, particularly in developing countries such as Pakistan, which falls within the "stone forming belt" region. This rise has underscored the need for effective management strategies for obstructive uropathy, a potentially reversible condition if timely intervention is provided. However, the literature reveals a divergence in treatment approaches between different regions and among healthcare professionals, with no universally recommended treatment for relieving the obstructed system. Objective: This study aimed to evaluate and compare the efficacy of percutaneous nephrostomy (PCN) versus Double J stent (DJS) in the management of obstructive uropathy secondary to urolithiasis in patients with elevated serum creatinine levels. Methods: Conducted as a randomized controlled trial at the Jinnah Postgraduate Medical Center Karachi from January 2023 to December 2023, the study included patients aged 20 to 50 years with obstructive uropathy secondary to urolithiasis and serum creatinine above or equal to 2.0 mg/dL. Exclusion criteria encompassed obstructive uropathy due to bladder outlet obstruction, uncontrolled coagulopathy, and lack of consent. Participants were randomized into two groups for either PCN or DJS placement, with pre-operative and post-procedure serum creatinine and urea levels measured at multiple intervals. Data analysis was performed using SPSS version 25. Results: The study enrolled 30 patients in the PCN group and 30 in the DJS group. Efficacy rates for PCN and DJS were 93.3% (28 out of 30) and 76.7% (23 out of 30), respectively. Stratified analysis revealed no statistically significant differences in efficacy based on age, gender, or duration of illness, although a trend favoring PCN was observed in patients over 40 years and those treated within 5-10 days of illness onset. Conclusion: While both PCN and DJS are effective interventions for obstructive uropathy secondary to urolithiasis, PCN showed a non-significantly higher overall efficacy. These findings suggest a potential preference for PCN in certain patient subsets, though further research with larger sample sizes and multi-center trials is needed to substantiate these observations.

Experienced disrespect & abuse during childbirth and associated birth characteristics: a cross-sectional survey in the Netherlands

BackgroundExperiencing upsetting disrespect and abuse (D&A) during labour and birth negatively affects women’s birth experiences. Knowing in what circumstances of birth women experience upsetting situations of D&A can create general awareness and help healthcare providers judge the need for extra attention in their care to help reduce these experiences. However, little is known about how different birth characteristics relate to the experience of D&A. Previous studies showed differences in birth experiences and experienced D&A between primiparous and multiparous women. This study explores, stratified for parity, (1) how often D&A are experienced in the Netherlands and are considered upsetting, and (2) which birth characteristics are associated with these upsetting experiences of D&A.MethodsFor this cross-sectional study, an online questionnaire was set up and disseminated among women over 16 years of age who gave birth in the Netherlands between 2015 and 2020. D&A was divided into seven categories: emotional pressure, unfriendly behaviour/verbal abuse, use of force/physical violence, communication issues, lack of support, lack of consent and discrimination. Stratified for parity, univariable and multivariable logistic regression analyses were performed to examine which birth characteristics were associated with the upsetting experiences of different categories of D&A.ResultsOf all 11,520 women included in this study, 45.1% of primiparous and 27.0% of multiparous women reported at least one upsetting experience of D&A. Lack of consent was reported most frequently, followed by communication issues. For both primiparous and multiparous women, especially transfer from midwife-led to obstetrician-led care, giving birth in a hospital, assisted vaginal birth, and unplanned cesarean section were important factors that increased the odds of experiencing upsetting situations of D&A. Among primiparous women, the use of medical pain relief was also associated with upsetting experiences of D&A.ConclusionA significant number of women experience upsetting disrespectful and abusive care during birth, particularly when medical interventions are needed after the onset of labour, when care is transferred during birth, and when birth takes place in a hospital. This study emphasizes the need for improving quality of verbal and non-verbal communication, support and adequate decision-making and consent procedures, especially before, during, and after the situations of birth that are associated with D&A.

My Body Is My Temple? Comparing Sexual Crimes and Property Crimes in a Human Rights Tradition

AbstractDespite recent criminal law reforms to define rape through the lack of consent, practical questions remain about how to regulate different kinds of violations of sexual autonomy. Many common law scholars have found it eye-opening how much more extensive and easily accepted the protection of property rights is compared to the protection of sexual autonomy. But when the rationale of criminalization resides in human rights, such a comparison is alien; protecting human dignity appears separate from protecting instrumental property rights. Considering rape a subversion of our ownership rights to our bodies (the property model of rape) is rightly regarded as problematic. This article argues that comparing sexual crimes and property crimes is not predicated on the property model but rather on autonomy itself. Comparisons based on autonomy could help resolve practical dilemmas of consent-based rape laws while respecting human dignity and thus be fruitful research pursuits within a human rights tradition.

Violencia sexual y jóvenes: «no es algo con lo que naces, sino con lo que aprendes»

ObjectiveTo analyse the perceptions and experiences of young people in Spain about sexual violence (SV), its possible causes, victims and perpetrators.. MethodQualitative study based on semi-structured interviews with 22 young people between 18 and 24 years old. A qualitative content analysis was carried out. ResultsIn the juvenile narratives, the lack of definition and accuracy about what SV is stands out, except for mentioning rape, lack of consent and use of force in sexual relations. The girls, self-perceived as the main victims, also break with these narratives by providing a broader vision and gender inequalities related. In general, the most prevailed idea is that VS is perpetrated by men against women in heterosexual relationships inside and outside the couple. Regarding explanations, references coexist to both contextual factors (linked to gender inequalities and the social construction of sexual relationships) and behavioural factors (which includes the viewing of pornography). Tentatively proposals for improvement related to sexual and affective education emerge. ConclusionsIn the perceptions of the young people, ambiguity seems to coexist with explicit references to the different ways in which it manifests itself and the influence of gender inequalities. Sex and life experience appear to influence these narratives. It is necessary to promote a more critical perspective on the social construction of SV and intimate relationships in the young population.

Understanding the lived experience of pregnancy and birth for survivors of rape and sexual assault

BackgroundOne in five women in the UK are survivors of rape and sexual assault, and four in five women will give birth. This implies that a substantial number of women experience rape and sexual assault before pregnancy. We highlight and explore the voices and lived experiences of survivors during pregnancy and birth, to better understand the relationship between sexual violence, biomedicine, and pregnancy and to inform maternity care practice.MethodsThis qualitative research took an intersectional feminist approach. We conducted in-depth individual interviews in England with fourteen women who self-identified as survivors of rape or sexual assault, and who had experienced pregnancy and birth after the assault. We conducted open line-by-line coding of the interview transcripts, and identified key themes and sub-themes inductively.ResultsThree themes help summarise the narratives: control, safety and trauma. Maintaining a sense of control was important to survivors but they often reported objectification by healthcare staff and lack of consent or choice about healthcare decisions. Participants’ preferences for giving birth were often motivated by their desire to feel in control and avoid triggering traumatic memories of the sexual assault. Survivors felt safer when they trusted staff. Many participants said it was important for staff to know they were survivors but none were asked about this. Pregnancy and birth experiences were triggering when they mirrored the assault, for instance if the woman was prevented from moving. Many of our participants reported having unmet mental health care needs before, during or after pregnancy.ConclusionsSurvivors of sexual violence have specific maternity care needs. For our participants, these needs were often not met, leading to negative or traumatic experiences of pregnancy and birth. Systemic biases and poor birth experience jeopardise both psychological and physical safety. Funding for maternity and mental health services must be improved, so that they meet minimum staffing and care standards. Maternity services should urgently introduce trauma-informed models of care.

Gender-Based Violence Narratives in Internet-Based Conversations in Nigeria: Social Listening Study.

Overcoming gender inequities is a global priority recognized as essential for improved health and human development. Gender-based violence (GBV) is an extreme manifestation of gender inequities enacted in real-world and internet-based environments. In Nigeria, GBV has come to the forefront of attention since 2020, when a state of emergency was declared due to increased reporting of sexual violence. Understanding GBV-related social narratives is important to design public health interventions. We explore how gender-related internet-based conversations in Nigeria specifically related to sexual consent (actively agreeing to sexual behavior), lack of consent, and slut-shaming (stigmatization in the form of insults based on actual or perceived sexuality and behaviors) manifest themselves and whether they changed between 2017 and 2022. Additionally, we explore what role events or social movements have in shaping gender-related narratives in Nigeria. Social listening was carried out on 12,031 social media posts (Twitter, Facebook, forums, and blogs) and almost 2 million public searches (Google and Yahoo search engines) between April 2017 and May 2022. The data were analyzed using natural language processing to determine the most salient conversation thematic clusters, qualitatively analyze time trends in discourse, and compare data against selected key events. Between 2017 and 2022, internet-based conversation about sexual consent increased 72,633%, from an average 3 to 2182 posts per month, while slut-shaming conversation (perpetrating or condemning) shrunk by 9%, from an average 3560 to 3253 posts per month. Thematic analysis shows conversation revolves around the objectification of women, poor comprehension of elements of sexual consent, and advocacy for public education about sexual consent. Additionally, posters created space for sexual empowerment and expressions of sex positivity, pushing back against others who weaponize posts in support of slut-shaming narrative. Time trend analysis shows a greater sense of empowerment in advocating for education around the legal age of consent for sexual activity, calling out double standards, and rejecting slut-shaming. However, analysis of emotions in social media posts shows anger was most prominent in sexual consent (n=1213, 73%) and slut-shaming (n=226, 64%) posts. Organic social movements and key events (#ArewaMeToo and #ChurchToo, the #SexforGrades scandal, and the #BBNaija television program) played a notable role in sparking discourse related to sexual consent and slut-shaming. Social media narratives are significantly impacted by popular culture events, mass media programs, social movements, and micro influencers speaking out against GBV. Hashtags, media clips, and other content can be leveraged effectively to spread awareness and spark conversation around evolving gender norms. Public health practitioners and other stakeholders including policymakers, researchers, and social advocates should be prepared to capitalize on social media events and discourse to help shape the conversation in support of a normative environment that rejects GBV in all its forms.

Lithium Therapy in Old Age: Recommendations from a Delphi Survey.

While lithium (Li) has been well established for the treatment of bipolar disorder, geriatric patients require special attention when it comes to issues of drug safety. Declining renal function, amongst other medical conditions, and polypharmacy may pose increased risks. Only a few previous studies have addressed the management of Li in geriatric patients. Twenty-four German medical experts on geriatric medicine and Li treatment participated in a Delphi survey, consisting of two rounds of questionnaires and a final formulation of treatment recommendations. Three major issues of Li therapy were outlined: initiation of treatment, monitoring of ongoing therapy, and withdrawal due to medical reasons. Final recommendations were consented to at a threshold of at least 80% expert agreement. Final consensus was achieved on 21 clinical recommendations. The approved recommendations covered aspects of necessary laboratory checks, concomitant medication, and target Li serum concentration in geriatric patients. Concerning the termination of Li therapy, an agreement was reached on the appropriate time span for tapering and on potential alternatives to Li. No consensus was achieved on whether concomitant dementia or frailty should be considered contraindications for Li treatment and the appropriate threshold of the estimated glomerular function rate for withdrawing Li. According to the view of German experts, Li may be used in geriatric patients, but it should be monitored carefully. However, the lack of consent in several specific treatment situations underlines the need for research on specific issues of Li therapy.

Imposing a Lifestyle: A New Argument for Antinatalism.

Antinatalism is an emerging philosophy and practice that challenges pronatalism, the prevailing philosophy and practice in reproductive matters. We explore justifications of antinatalism-the arguments from the quality of life, the risk of an intolerable life, the lack of consent, and the asymmetry of good and bad-and argue that none of them supports a concrete, understandable, and convincing moral case for not having children. We identify concentration on possible future individuals who may or may not come to be as the main culprit for the failure and suggest that the focus should be shifted to people who already exist. Pronatalism's hegemonic status in contemporary societies imposes upon us a lifestyle that we have not chosen yet find almost impossible to abandon. We explicate the nature of this imposition and consider the implications of its exposure to different stakeholders with varying stands on the practice of antinatalism. Imposition as a term has figured in reproductive debates before, but the argument from postnatal, mental, and cultural imposition we launch is new. It is the hitherto overlooked and underdeveloped justification of antinatalism that should be solid and comprehensible enough to be used even by activists in support of their work.

Biobank as a legal category

The development of medical technologies increases the need for legal regulation of relations on the formation of biobanks. The comparative legal method and the formal legal method were used. Currently, the term biobank is used to denote both the totality of objects of rights and to denote the entity carrying out the storage. The conclusion is made about the need for additional regulation of the concept of biobank. To protect the rights and legitimate interests of the patient, it is necessary to take into account his consent or lack of consent both for the removal of cells and other biological materials, and for their storage, transportation, cryopreservation. The conditions of consent may provide for the destruction of biological material upon the occurrence of certain conditions, for example, in the event of the death of a patient. Consent to the processing of personal data should be obtained separately. For more complete regulation, it is necessary to determine the features of the legal personality of organizations engaged in professional activities for the storage of biological samples and related data. It should be recognized that it is expedient to preserve the rules on licensing the activities of such organizations.

Comparison the effects of sugammadex and neostigmine/atropine on cognitive functions in bariatric surgery patents: Randomized controlled trial

Background/Aim: A recently introduced drug, sugammadex, can be a good alternative to conventional neuromuscular blockade reversal agents, such as neostigmine. This choice is of great importance, especially in the patients in whom it would be wise to avoid cholinergic side effects. The aim of this study was to compare the effects of sugammadex and the combination of neostigmine/atropine on post-operative cognitive dysfunction in bariatric surgery patients. Methods: This randomized controlled trial included a total of 90 patients with American Society of Anesthesiologists (ASA) I–III physical status and body mass index &gt;30 who were scheduled for elective sleeve gastrectomy were recruited for the study after obtaining ethics committee approval. Written consent was obtained from each patient. The exclusion criteria consisted of several parameters: lack of consent, co-existing muscular diseases, and severe cardiovascular diseases (New York Heart Association [NYHA]). The patients were randomly divided into two groups, and the randomization was performed by the investigator using previously prepared envelopes. In both groups, Mini Mental State Examination (MMSE) was performed before the operation. The patients’ memory, attentive executive functions, and motor skills were evaluated as part of a control cognitive evaluation. After the operation while in the post-anesthesia care unit and when the Modified Aldrete Recovery Score was ≥9, the MMSE evaluation was repeated one and six hours later. Results: The pre-operative MMSE results were similar in both groups. In the post-operative period, MMSEpo, MMSEpo1, and MMSEpo6 values were not significantly different between the groups. When a detailed examination of MMSEpo data was performed, it was determined that the MMSE scores were 20–25 in 14 patients (32.6%) in Group N/A and six patients (14.6%) in Group S. In Group N/A, the percentage of patients with MMSE 20–25 was significantly higher than that of Group S (X2=3.807; P=0.046). Conclusion: In this study, sugammadex produced less effects on cognitive functions when compared with neostigmine/atropine combination. The neostigmine/atropine combination produced mild effects on cognitive functions in the first hour of recovery.

Barriers to Deceased Donor Procurements: The Saudi Experience.

Barriers to Deceased Donor Procurements: The Saudi Experience.

Shall We Establish Sexual Consent or Would You Feel Weird? Sexual Objectification and Rape-Supportive Attitudes as Predictors of How Sex is Negotiated in Men and Women

How sex is negotiated has reached greater interest because a lack of consent is considered to be a risk factor for sexual violence. However, the mechanisms underlying sexual consent still remain unexplored. The purpose of the present study was to examine the link between rape-supportive attitudes and objectification, as experienced by women and perpetrated by men, in the context of specific domains relevant to the establishment and negotiation of sexual consent, i.e., attitudes, beliefs and behaviors. The sample comprised 1682 participants (21.5% male, 78.5% female) aged 18–66 years (M = 23.41; SD = 6.96). In women, negotiation of consent was predicted both directly and indirectly by being sexually objectified by men, rape attitudes playing a mediating role. Women who were objectified reported lower efficacy with respect to asking for consent and considered explicit establishment of consent as important. In men, only the perpetration of unwanted sexual advances predicted how they negotiate consent, in which rape attitudes played a mediating role (indicating a maladaptive pattern of negotiation). Our findings could be useful for the design and implementation of intervention programs that address both victims and perpetrators of violence.

Hypovitaminosis D in post bariatric patients: Narrative review

Obesity can be associated with several diseases, signs, and symptoms. Among them, there is nutrient deficiency, especially vitamin D, which regulates calcium and phosphate and helps in bone remodeling. Vitamin D deficiency is related directly to the inadequate intake of foods rich in vitamins, less exposure to the sun and, mainly, to the sequestration of fat-soluble vitamins by the adipose tissue, making it even more difficult for the body to absorb them. Among these complications is the worsening of vitamin deficiency, with a focus on vitamin D, which is already present before the patient undergoes bariatric surgery. Regarding the types of bariatric surgery, each one establishes a degree of vitamin D deficiency that the patient will have postoperatively. That is, each type of bariatric surgery, as they are performed in different ways, directly interfere with the patient's absorption of vitamins. Postoperatively, vitamin D supplementation is recommended for all patients. However, due to poor patient compliance and lack of consent among physicians on the best form of supplementation, the deficiency is maintained, further impairing the treatment, and causing a worsening of the bariatric patient's condition.

Expression of heat shock proteins HSPA1A, HSPA1B and TP53 in vulval lichen planus and vulval lichen sclerosus.

Heat shock proteins (HSPs) are proteins involved in protein folding and maturation. HSP expression is induced by heat shock or other stressors including cellular damage and hypoxia. The major groups, which are classified based on their molecular weight, include HSP27, HSP40, HSP60, HSP70, HSP90, and large HSP (HSP110 and glucose-regulated protein 170). The comparison of heat shock proteins and TP53 expression is yet not well studied in both vulval lichen sclerosus and lichen planus. Our aim was to assess the HSP and TP53 gene expression in women suffering from LS or LP and compare it within these groups and also healthy controls. The inclusion criteria were willingness to donate vulval biopsies, not currently or in the prior two weeks received any local nor systemic treatment for vulval disorder, age > 18 years old. The exclusion criteria were lack of consent, current vaginal infection confirmed with microbiological studies, current local or systemic treatment for vulval disease. 45 consecutive women were recruited into the study. All appropriate vulval samples were process by genetic analysis. The mean expression (± SD) of HPSA1A for controls was 5.52 ± 3.18, for LS was 7.44 ± 2.16 and for LP was 7.89 ± 2.48. The mean expression (± SD) of HPSA1B for controls was 6.54 ± 3.41, for LS was 9.94 ± 6.88 and for LP was 9.43 ± 2.31. The mean expression (± SD) of TP53 for controls was 9.11 ± 1.14, for LS was 9.94 ± 1.27 and for LP was 10.41 ± 2.00. HSPA1A expression was 3,8 higher in women with lichen sclerosus than in control group. Heat shock protein-70 is more often expressed in LS than in healthy controls. HSP-70 not only supports tumor growth and metastasis, but on the other hand mat help to develop immune-driven treatment strategies.

Defining Rape: The Problem with Consent

Rape is one of the most commonly reported crimes all over the world. It is a crime under both international and national law although it is still primarily prosecuted before domestic courts. The traditional common law definition of rape articulates three elements of the crime of rape; vaginal penetration, lack of consent and direct participation of the accused person. However, many jurisdictions are moving away from consent-based definitions of rape. Through a feminist lens, this paper explores the place of consent as an element of the crime of rape. It undertakes a comprehensive review of literature and case law and makes an analysis of the articulation of consent as an element of the crime of rape at both national and international levels. It establishes that the legal definition of rape has a significant impact on the prosecution of rape cases and on the victim of rape. If the definition is based on the need for the prosecution to prove the lack of consent, then the legal process is focused on her behaviour and reaction to the sexual assault. It concludes that a definition of rape based on lack of consent is problematic and hinders access to justice for rape victims and it is inconsistent with the contemporary understanding of rape as a crime of sexual violence.